Ameloblastoma: Our clinical experience with 68 cases

Abstract

Introduction: In this environment, previous workers have reported on the challenges of managing large sized ameloblastoma of the jaws with less than adequate facilities. The aim of this review is to present the management of 68 cases of ameloblastoma with emphasis on surgical care. Materials and Methods: Retrospective survey of case notes of patients with histopathologic diagnosis of ameloblastoma (using the criteria of Barnes et al., 2005) seen between January 2006 and August 2010 at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria was undertaken. Data collected includes histopathological diagnosis, age, gender, clinical information on site of lesion, form of intubation and surgical procedure performed. Results: Out of 94 patients, 68 with histological diagnosis of ameloblastoma (59 mandibular and 9 maxillary) were operated within the study period. The remainder (26) was not treated in hospital. Among 68 patients treated, more were males (38) than females (30), giving a male to female ratio of 1.3:1. The age range was between 14 and 74 years (mean-standard deviation). The duration of the symptoms ranged from 7 months to 24 years, most were follicular ameloblastoma (n = 13) followed by acanthomatous type (n = 7). Endotracheal intubation was the most common (n = 55) followed by fiber optic laryngoscopy (n = 8). The surgical approach most used was extended Risdon with intraoral (n = 24) followed by extended Risdon with lip split and intraoral (n = 17). Segmental resection (en block) formed the bulk of our procedures (n = 22) followed by subtotal mandibulectomy (n = 16). Conclusion: The treatment of ameloblastoma remains controversial. Its destructive nature has left patients with wide defects difficult to reconstruct.