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Ameloblastoma: clinical features and management of 21 cases
1Department of Surgery, Faculty of Medicine, Addis Ababa University, P.O.Box 9086, Addis Ababa.
Insights
This study on ameloblastoma in 21 patients found it is a disabling but curable disease. Radical surgical excision is recommended to prevent recurrence of this jaw tumor.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Pathology
Background:
- Ameloblastoma is a rare odontogenic tumor with a high recurrence rate.
- Understanding its clinical presentation and treatment outcomes is crucial for patient management.
Purpose of the Study:
- To report the clinical features, management, and outcomes of ameloblastoma patients treated at Tikur Anbessa Hospital.
- To evaluate the effectiveness of surgical interventions and identify factors influencing recurrence and complications.
Main Methods:
- Retrospective analysis of 21 ameloblastoma cases operated between 1990 and 1997.
- Data collection included patient demographics, clinical presentation, diagnostic methods, surgical procedures, and post-operative outcomes.
- Diagnosis was confirmed through clinical evaluation, radiography, fine needle aspiration cytology, and excisional biopsy.
Main Results:
- The study included 21 patients (14 male, 7 female) with a mean age of 26 years.
- Common clinical features were pain on chewing (78%) and mandibular swelling (56%).
- Surgical management included hemimandibulectomy, segmental resection, and local resection/curettage, with two recurrences observed. Post-operative complications like infection and salivary fistula occurred in 55% of patients.
Conclusions:
- Ameloblastoma, though predominantly benign, can be disabling and requires aggressive surgical management.
- Radical excision is the recommended treatment to minimize recurrence risk.
- Effective surgical planning and post-operative care are essential to improve outcomes and reduce complications.
Abstract:
A retrospective study of 21 patients with ameloblastoma, operated in Tikur Anbessa Hospital between September 1990 to August 1997, is reported. There were 14 male and 7 female patients. The mean age at diagnosis was 26 years. There were three paediatric patients aged 6,9 and 12 years. The average duration of illness was 4 years with a wide range of 3 months to 12 years. Complete medical record was recovered for 9 patients. Clinical features were pain on chewing in 7 out of 9 (78%) and mandibular swelling in 5 out of 9 (56%) of which there was ulceration with bloody and/or purulent discharge. Diagnosis was made by clinical presentation, x-ray of the mandible and fine needle aspiration cytology. Two patients had malignant ameloblastoma as confirmed by excisional biopsy. All patients were managed surgically. Of nine patients whose clinical records could be retrieved, five had hemimandibulectomy, two had segmental resection and two had local resection and curettage. Recurrences were seen in two patients. Post-operative stay was complicated by infection and salivary fistula in 55%; these patients were discharged after 29.6 days as compared to 14 days in those that were not complicated. One patient with malignant tumor needed tracheostomy and intensive care for one week. There were no deaths. Ameloblastoma is predominantly a benign disabling but curable disease. Radical excision is recommended to avoid recurrence.