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Ameloblastoma: Management and Outcome.

Mohammad Adeel1, Muhammad Shaheryar Ahmed Rajput2, Asif Ali Arain3

  • 1Head and Neck Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK.

Cureus
|December 15, 2018
PubMed
Summary

Ameloblastoma management requires complete excision and reconstruction. Segmental mandibulectomy with free tissue transfer offers good functional and aesthetic outcomes, minimizing recurrence risk.

Keywords:
ameloblastomafree fibular flapmulticystic ameloblastomaodontogenic tumoropgorthopantomogramsolid ameloblastomatumors and cysts of jawunicystic ameloblastoma

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Oncology
  • Reconstructive Surgery

Background:

  • Ameloblastoma is a destructive odontogenic tumor with high recurrence rates.
  • Effective management necessitates radical resection and defect reconstruction.
  • Challenges include achieving oncologic control and functional restoration.

Purpose of the Study:

  • To evaluate outcomes of ameloblastoma treatment.
  • To assess the efficacy of different surgical and reconstructive techniques.
  • To identify factors influencing recurrence and patient satisfaction.

Main Methods:

  • Retrospective review of 15 ameloblastoma patients (1991-2009).
  • Analysis of medical records, imaging, and operative/pathology reports.
  • Surgical interventions included segmental mandibulectomy, maxillectomy, and enucleation with various reconstruction methods.

Main Results:

  • 13 tumors originated in the mandible, 2 in the maxilla.
  • Segmental mandibulectomy with free tissue transfer showed high success rates.
  • Enucleation alone was associated with recurrence; reconstruction with free flaps had no flap loss.

Conclusions:

  • Segmental mandibulectomy with a 1 cm disease-free margin and immediate free tissue transfer reconstruction yields favorable results.
  • This approach ensures satisfactory speech, cosmesis, and mastication.
  • Careful surgical planning is crucial for optimal ameloblastoma management.