Simple Curettage Research Articles

Clinical analysis of 1,038 cases of odontogenic jawbone cysts

BackgroundThis study aims to analyse the clinical characteristics of different types of odontogenic jawbone cysts (OJCs) and to provide a theoretical basis for prevention and clinical treatment.MethodsData from 1,038 patients with OJCs were collected, and relevant information, such as sex, age, clinical symptoms and signs, imaging data, number of lesions, lesion location, pathological diagnosis, clinical treatment and prognosis, was statistically analysed.ResultsAccording to the World Health Organization (WHO) classification of OJCs in 2022, the highest incidence rate was observed for radicular cysts (RCs), accounting for 58.96% of the total number of cases, followed by dentigerous cysts (DCs), accounting for approximately 23.22% of cases. lateral periodontal cysts (LPCs) and calcifying odontogenic cysts (COCs) comprised the lowest number of cases. The age distribution of patients was between 4 and 89 years, and the high incidence age group was youth and middle age, accounting for 66.67% of the total number of cases. The male-to-female ratio of patients was 1.51:1, and there was a statistically significant difference between the sexes(p < 0.05).In terms of the site of incidence, odontogenic keratocysts (OKCs) were prevalent in the mandibular molar region. In addition, mandibular ramus, inflammatory collateral cysts (ICCs) and dentigerous cysts (DCs) were more common in the mandibular third molar, and radicular cysts (RCs) and calcifying odontogenic cysts (COCs) were prevalent in the maxillary anterior region. On imaging, 955 (92.0%) lesions were solitary, and 83 (8.0%) were multiple. The treatment included four types of surgery, including simple curettage, marsupialization, marsupialization followed by secondary curettage, and partial resection of the jaw, and a total of 921 patients were followed up, with a recurrence rate of 2.82%.ConclusionsOJCs are more common in males than in females, and a statistically significant difference is observed in the most prevalent types of cysts occurring at different ages and in various regions of the jawbone (p < 0.05). Early diagnosis should be made with the help of X-rays, age, location, and clinical symptoms. In addition, appropriate treatment methods should be selected, and long-term follow-up observation is needed.

Management of dermatosis papulosa nigra: a systematic review.

Dermatosis papulosa nigra (DPN) is a variant of seborrheic keratosis that typically presents as hyperpigmented pedunculated papules on the face, trunk, and/or back in those with skin of color. Although benign, the lesions can cause significant discomfort and distress. Management options are limited and often unaffordable, as treatment is elective in most cases. This study was undertaken to provide an updated summary of safe and efficacious treatments for DPN. Five databases were searched to identify full-text publications reporting on treatments and outcomes in adults with DPN. Seventeen publications met inclusion criteria and were included: six cohort studies, one randomized controlled trial, five case report studies, one case series, and four pilot studies. Treatment options included simple excision, curettage, electrodesiccation, cryotherapy, topicals, and laser therapies. These modalities varied in their documented outcomes and associated potential adverse effect profiles. Postinflammatory hyperpigmentation is a common adverse effect that often leads to patient dissatisfaction. It can be mitigated with topical treatments aimed at reducing local inflammation. Study limitations included small sample size in individual studies, lack of consistent reporting of Fitzpatrick skin type, and lack of comparison to the standard treatment of electrodesiccation or curettage. Ultimately, treatment should consider the patient's Fitzpatrick type, treatment area, associated costs, and potential adverse effects.

FUNCTIONAL OUTCOME OF GIANT CELL TUMOR OF DISTAL RADIUS AFTER EN-BLOC RESECTION AND NON-VASCULARIZED FIBULAR BONE GRAFTING

Introduction: Giant cell Tumors (GCT) are relatively common lesions that are most often encountered in middle aged women [Salunke AA, Shah J, Warikoo V, Chakraborty A, Pokharkar H, Chen Y, Pruthi M, Pandit J. Giant cell tumor of distal radius treated with ulnar translocation and wrist arthrodesis. J Orthop Surg 2017 25(1): 2309499016684972, 2017, https://doi.org/10.1177/2309499016684972 ]. As 25% of these are usually locally aggressive, early diagnosis, and treatment are of paramount importance [Dorfman HD, Czerniak B. Bone Tumors. St. Louis, Mosby (1998)]. Due to the high incidence of local recurrence following simple curettage, it is no longer a preferred line of treatment. In recent times, extended curettage, wide resection or en-bloc resection with bone grafting have supplanted simple curettage [Şirin E, Akgülle AH, Topkar OM, Sofulu Ö, Baykan SE, Erol B. Mid-term results of intralesional extended curettage, cauterization, and polymethylmethacrylate cementation in the treatment of giant cell tumor of bone: A retrospective case series. Acta Orthop Traumatol Turc 54(5): 524–529, 2020, https://doi.org/10.5152/j.aott.2020.19082 ]. Case Scenario: A 22-year-old female patient presented to the OPD with a swelling in her right wrist which she noticed two years back. The swelling gradually increased to the size of a lemon at presentation and was initially painless but eventually became painful. The patient was evaluated based on clinical history, examination, and radiography. A clinical and radiological diagnosis of GCT of the distal radius was made. FNAC was done to confirm the same. Further, the lungs were screened for metastasis. She underwent en-bloc resection of the lesion followed by reconstruction with non-vascularized proximal fibular autograft secured with a DCP and [Formula: see text] -wires. The excised specimen was dispatched for Fig. 1. The swelling at presentation histopathological examination and confirmed to be a Giant Cell Tumor. Regular follow-up schedule was initiated at 2 weeks, 6 weeks, 3 months, 1 year, 36 weeks, and 2 years postoperatively. Her functional outcome was monitored by assessing the wrist range of movements and the Mayo wrist scores. Results: The patient’s Mayo wrist scores showed an increasing trend during follow-up, indicating improved functional outcomes. Recurrence was not noted during the follow-up period. Discussion: Tumor in the distal radius metaphyseoepiphyseal region is commonly associated with extracompartmental involvement, cortical invasion, and pathologic fracture [Yang YF, Wang JW, Huang P, Xu ZH. Distal radius reconstruction with vascularized proximal fibular autograft after en-bloc resection of recurrent giant cell tumor. BMC Musculoskelet Disord 17(1): 346, 2016. https://doi.org/10.1186/s12891-016-1211-8 ]. Hence, curettage is not an optimal method in the distal radius. Thus, wide excision is the optimal choice of treatment. However, this creates a defect at the distal end of the radius. The preferred options for the management of the defect comprise of osteoarticular allografts, vascularized grafts, non-vascularized bone grafts, and custom-made prostheses [Saini R, Bali K, Bachhal V, Mootha AK, Dhillon MS, Gill SS. En bloc excision and autogenous fibular reconstruction for aggressive giant cell tumor of distal radius: a report of 12 cases and review of literature. J Orthop Surg Res 6 : 14, 2011, https://doi.org/10.1186/1749-799X-6-14 ]. Vascularized bone grafts have been proposed to have a better union rate and lesser complication rate as compared to non-vascularized options. Thus, with our case report, we would like to highlight the effectiveness of the non-vascularized proximal fibular autograft in the reconstruction following en bloc excision of the distal radius. Conclusion: Hence, en-bloc resection and non-vascularized fibular bone grafting is a valuable method of treatment of GCTs of the distal radius. It is also associated with low recurrence rates and improved wrist function in the course of follow-up.

Functional and oncological outcome of patients with benign hindfoot tumors treated by curettage

BackgroundOnly 3 % of osseous tumors occur in the foot. The metatarsals are the –most common site whereas the calcaneus and talus are less common sites. Because these tumors are rare, the aim of our study is to assess the functional and the oncological outcome of patients with benign hindfoot tumors managed by curettage. MethodsThe clinical and radiological data of 41 patients diagnosed with benign hindfoot tumors were retrospectively reviewed. The study included 31 males and 10 females. The average age was 23.68 (range, 5–49) years. The average follow-up period was 92.7 (range, 12–244) months. ResultsAt the last follow-up visit, the average Musculoskeletal Tumor Society scoring system (MSTS) score was 28.12 (range, 21–30). MSTS scores were higher in patients with latent tumors (P = .028) and patients managed by simple curettage (P = .018). The recurrence rate in calcaneal tumors was higher than those in the talus. The overall complication rate was 12.2 % (5 of 41 patients). Infection and subtalar arthritis were the most common complications. ConclusionCurettage of benign bone tumors of talus or calcaneus proved to be an effective method in the management of these patients. Their functional outcome is also excellent. All the complications are manageable without long term morbidity. Level of evidenceLevel IV Therapeutic study.

Odontogenic myxoma of the mandible: a case report.

We present the unusual case of an odontogenic myxoma involving a 37-year-old female patient, which had acquired large dimensions and involved the right half of the mandible, including the ramus; the patient was treated with large resection surgery, with satisfying medium-term results. Early diagnosis of such lesions is very important, as the patient avoids extensive surgical procedures that involve losing a large part of the jawbones and their subsequent impact on the patient's quality of life. Although there is no fixed treatment plan for the management of odontogenic myxoma, treatment includes surgical management that may range from simple enucleation and curettage to surgical excision; wide surgical resection is appropriate for cases of large size to avoid recurrence.

Construction and evaluation of intrauterine adhesion model in rats by different methods of mechanical injury.

The study aimed to establish a stable and effective animal model for the experimental study of intrauterine adhesion (IUA) by evaluating various mechanical injury methods. A total of 140 female rats were divided into four groups according to the extent and area of endometrial injury: group A (excision area: 2.0 × 0.5 cm2), group B (excision area: 2.0 × 0.25 cm2), group C (endometrial curettage) and group D (sham operation). On the 3rd, 7th, 15th and 30th day after the operation, the tissue samples of each group were collected, and the uterine cavity stenosis and histological changes were recorded by HE and Masson staining. Immunohistochemistry of CD31 was applied to visualize microvessel density (MVD). The pregnancy rate and the number of gestational sacs were used to evaluate the reproductive outcome. The results showed that endometrium injured by small-area endometrial excision or simple curettage could be repaired.The ratio of fibrosis in groups A and B was higher than that in groups C and group D 30days after modeling (P < 0.001). The number of endometrial glands and MVD in group A was significantly lower than those in groups B, C and D (P < 0.05). The pregnancy rate in group A was 20%, which was lower than that in groups B (33.3%), C (89%) and D (100%) (P < 0.05). Full-thickness endometrial excision has a high rate of success in constructing stable and effective IUA models in rats.

Simple curettage and allogeneic cancellous bone chip impaction grafting in solitary enchondroma of the short tubular bones of the hand

Enchondroma is the most common bone tumor in the hand. While standard surgical procedure is intra-lesional excision and bone grafting, there is a dispute between allogeneic bone, autogenous bone, and synthetic bone substitute grafting. Diverse adjuvant treatments have been introduced to reduce recurrence, but results are mixed with controversies. Meanwhile, whether existing descriptive classification could predict treatment outcome remains unclear. Thus, we reviewed patients with solitary enchondroma of the hand who underwent simple curettage followed by allogeneic cancellous bone chip impaction grafting. Eighty-eight patients with more than 5 years of follow-up were enrolled. Demographic data, local recurrence, and complications were reviewed. Duration of consolidation and the difference according to Takigawa classification were assessed. Range of motion (ROM), and functional scores were also evaluated. There were 51 women and 37 men, with a mean age of 37.9 years. Mean follow-up was 10.2 years. Recurrence occurred only in one patient. There was no complication. Mean postoperative total active motions of fingers and thumb were 239° and 132.9°. Mean modified Disabilities of the Arm, Shoulder, Hand score, and Musculoskeletal Tumor Society Score were 1.63, and 99.2 at the last follow-up. Consolidation, ROM, and functional scores according to Takigawa classification showed no significant differences. This study suggests that simple curettage with impaction grafting of allogeneic cancellous bone chip is a feasible method for treating solitary enchondromas involving short tubular bone of the hand with good long-term outcomes. Postoperative recurrence and complication rates were very low. Radiographic and clinical results were good regardless of the previous radiological classification.

Clinical Presentation, Management and Outcome of Gestational Trophoblastic Diseases Admitted in Chittagong Medical College Hospital

Background: Gestational Trophoblastic Disease (GTD) is a heterogeneous group of diseases that includes partial and complete hydatidiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumour. The study aimed to determine the clinical presentation management options and outcome of GTD in patients admitted in a tertiary hospital of Bangladesh.&#x0D; Materials and methods: This prospective observational study included 50 patients with GTD from the Obstetrics and Gynaecology Department of Chittagong Medical College Hospital, during the period of July 2013 to December 2013. The demographic profile, clinical presentation, management, outcome and complications were studied.&#x0D; Results: Mean age was 25.40 ± 8.34 years with most of the patients (46%) were in age group 20 - 29 years. 42% participants were primigravida. The commonest symptom after bleeding per-vaginum (94%) was amenorrhea (90%). Maximum cases (80%) were of complete hydatidiform mole. Rate of progression to invasive mole and choriocarcinoma were found 6% and 10% respectively. Suction evacuation and hysterectomy were the treatment option. One patient (2%) expired due to excessive bleeding.&#x0D; Conclusion: The majority of cases are cured by simple suction uterine curettage. Regular follow up is important to estimate the true incidence of this disease.&#x0D; JCMCTA 2021 ; 32 (2) : 128-131

Bilateral simple bone cyst in mandible: Rare case report

The simple bone cyst is a benign osteolytic lesion, uncommon in the maxillomandibular region. Its etiology remains unknown, although traumatic injuries are often associated with this injury. Young patients, men and women alike are the most affected. It is asymptomatic in most cases, being diagnosed on routine radiographs. The radiolucent image, uni or multilocular, is well defined, with irregular margins, mainly in the posterior region of the mandible. Bilateral presentation is unusual. The final diagnosis is made during surgical procedures when an empty bone cavity is detected. Simple curettage is the treatment of choice and it consists of causing bleeding and filling the cavity with a blood clot. Bone repair will be observed in the follow-up procedures. The aim of this study was to present a rare case of bilateral simple bone cyst in a young male, treated with curettage of the bone walls.

Giant Cell Reparative Granuloma Presented as Nasal Mass: A Rare Entity

Giant Cell Reparative Granuloma (GCRG) is an unusual non-neoplastic lesion which most commonly involves maxilla and mandible. We present a case of GCRG of the nasal cavity in a young female presented with the complaint of progressively nasal obstruction. Radiological findings are usually nonspecific in this entity, therefore a good clinical, radiological and pathological correlation is needed for final diagnosis and to differentiate it from other giant cell lesions. Surgical excision is the preferred treatment modality over simple curettage.

Management of benign bone tumours

Benign bone tumours are rare, occurring most commonly in skeletally immature patients, usually arising from cartilage or bone. The commonest locations are the distal femur, proximal tibia and proximal humerus. They present with pain, swelling, pathological fracture or as incidental findings. Diagnosis is by a combination of radiography, MRI, CT and core needle biopsy if indicated. More aggressive benign tumours may appear radiologically similar to malignant tumours. Management depends upon anatomical location, symptoms, morbidity of treatment and the natural history of the tumour. In most cases it involves either simple excision or curettage, although occasionally it is necessary to perform a complete excision using similar principles as for malignant tumours.

Lumbar Spine Aneurysmal Bone Cyst

An Aneurysmal Bone Cyst (ABC) is a benign, locally aggressive, vascular, and expansile bony tumor of idiopathic etiology containing multiple thin-walled blood-filled channels, mostly diagnosed in pediatric and adolescent age groups. These lesions can cause local pain, pathological fractures, spinal deformity, and neurological deficits. The treatment of choice for ABC is highly debatable according to the literature. The treatment choices are simple curettage and grafting, complete surgical resection with or without prior selective arterial embolization, radiotherapy, or a combination of these procedures according to the case. Each modality is having different outcomes, technical requirements, and complications. We are reporting a case of Aneurysmal Bone Cyst of the lumbar spine in a young patient treated by surgery.

The prognosis of giant cell tumor of bone and the vital risk factors that affect its postoperative recurrence: a meta-analysis.

BackgroundThe purpose of this study is to analyze the overall prognosis of giant cell tumor of bone (GCTB) and the risk factors that affect its postoperative recurrence.MethodsThe databases of PubMed, Cochrane, Web of Science, Embase, China national knowledge infrastructure, China Biology Medicine disc, and Wanfang were searched until 20 June 2020. Following patients, intervention, comparator, outcomes, study design (PICOS) guidelines, eligible articles were defined as studies evaluating the overall prognosis of GCTB and the risk factors that affect its postoperative recurrence. The association between five risk factors (surgical methods, whether there is soft tissue invasion, tumor size, p53 expression, vascular endothelial growth factor (VEGF) expression) and the recurrence of GCTB were calculated using fixed-effects or random-effects models. The heterogeneity of the odd ration (OR) and effect size (ES) of each study was quantified using Cochran’s Q test and Higgins-I2 statistic. The publication bias was analyzed through the drawing of the funnel diagram.ResultsA total of 10 studies were included in the study. We found that the probability of recurrence of patients who choose simple curettage is 5.75 times that of patients who choose amputation or total resection. Patients with soft tissue invasion are 3.76 times more likely to relapse than non-invasive GCTB. The probability of recurrence of patients with tumors larger than 5 cm is 2.8 times that of patients with tumors smaller than. Patients with positive expression of p53 are 3.82 times more likely to relapse than patients with negative expression. And patients with positive expression of VEGF are 3.82 times more likely to relapse than patients with negative expression.ConclusionsIn conclusion, our analysis of five risk factors can be used to measure the recurrence of GCTB and provide important preoperative recommendations for patients with GCTB.

Review of 5-Fluorouracil is Associated With a Decreased Recurrence Risk in Odontogenic Keratocyst Management: A Retrospective Cohort Study

The odontogenic keratocyst (OKC) is 1 of the developmental cysts found in the maxillofacial region, and although overall relatively uncommon, it can be seen with some frequency by the oral and maxillofacial surgeon or surgical resident. The OKC is seen in patients of a wide range of ages, with the peak incidence in the second and third decades. It is more common in men than in women. 1 Fonseca R. Abaza N. El-Mofty S. Miller A. ed 3. Oral And Maxillofacial Surgery. Vol 2. Elsevier, St. Louis, MO2018: 338-390 Google Scholar Keratocysts are estimated to comprise roughly 12 to 14% of all odontogenic cysts. 2 Dashow J.E. McHugh J.B. Braun T.M. et al. Significantly Decreased recurrence rates in keratocystic odontogenic tumor with simple enucleation and curettage using Carnoy’s versus modified Carnoy’s solution. J Oral Maxillofacial Surg. 2015; 73: 2132 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar Compared with other odontogenic cysts, OKCs have a comparatively high recurrence rate after enucleation alone (up to 60%) and behave more aggressively in some cases. 3 Caminiti MF, El-Rabbany M, Jeon J, Bradley G: 5-Fluorouracil is associated with a Decreased recurrence risk in odontogenic keratocyst management: A retrospective cohort study. J Oral Maxillofacial Surg, 2020. https://doi.org/10.1016/j.joms.2020.07.215, accessed January 11, 2021 Google Scholar They are believed to arise from remnants of the dental lamina or the basal cell layer of the oral epithelium. 1 Fonseca R. Abaza N. El-Mofty S. Miller A. ed 3. Oral And Maxillofacial Surgery. Vol 2. Elsevier, St. Louis, MO2018: 338-390 Google Scholar Mandibular lesions are far more common than maxillary lesions (69 to 83% occur in the mandible), with the mandibular angle being the most frequent location. Although patients may experience pain, swelling, and/or discharge, most are asymptomatic and lesions are found on routine dental examinations and radiographs in which OKCs present as unilocular or multilocular radiolucencies. 4 Akhter Lone P. Ahmed Wani N. Ahmed Janbaz Z. et al. Topical 5-fluorouracil application in management of odontogenic keratocysts. J Oral Biol Craniofac Res. 2020; 10: 404 Crossref PubMed Scopus (2) Google Scholar

Monostotic fibrous dysplasia of fibula: a rare case report

&lt;p&gt;Fibrous dysplasia is a developmental anomaly of bone formation that may exist in monostotic or polyostotic form. Monostotic fibrous dysplasia of fibula is a rare case with unusual site and most common sites being facial bones, ribs, proximal femur and tibia. We report a case of 10-year-old boy attended our hospital with occasional pain in left leg while having strenuous activity. On clinical examination there was no obvious swelling with normal appearing skin. Radiographic examination revealed lesion with both radiopaque and radiolucent features showing a “ground-glass” appearing lesion in proximal one third of fibula. Differential diagnosis considered are simple bone cyst, non-ossifying fibroma, osteo-fibrous dysplasia, adamantinoma. As a definitive treatment curettage was done and biopsy sent for histopathological examination, which confirmed he diagnosis. Follow up after 10 months shows normal bone growth as evidenced radiologically and patient is asymptomatic. Case in detail and recent review of literature has been discussed. From our case, we have shown that it is possible to treat uncomplicated fibrous dysplasia with minimally invasive approach of simple curettage. Patient is symptomatically relieved within 2 months without any complications.&lt;/p&gt;

Non-surgical management of central giant cell granuloma with calcitonin nasal spray in an 8-year-old patient: Radiographic presentation

The central giant cell granuloma (CGCG) presents as a benign, painless, slow-growing swelling of the jaw. These lesions are reported more frequently in females and most often occur in the mandible. Radiographically, it presents as a distinct delineated bony pathology with a loss of lamina dura around teeth. There can be frequent signs of displacement of teeth and tooth germs. Currently, the usually followed surgical treatment of the CGCG ranges from simple curettage to en -bloc resection. The extensive resection of aggressive and larger lesions inevitably results in the loss of teeth and tooth germs, especially in younger patients. Since, calcitonin has a direct inhibiting effect on osteoclasts and is efficient in controlling diseases with increased osteoclast activity, such as Paget’s disease, and osteoclastic bone metastases, hence serve as a promising alternative. This paper presents the effectiveness and safety of Calcitonin nasal spray, in the management of a CGCG of the jaw, in an 8-year-old patient who was given calcitonin as first-line therapy.

Study on influencing factors and related clinical issues in cesarean scar pregnancy

Objective: This study aims to investigate the etiological and bleeding risk factors of cesarean scar pregnancy (CSP) and attempts to determine the clinical value of uterine artery embolization (UAE) combined with curettage, methotrexate (MTX) chemotherapy combined with curettage, and uterine curettage alone in terminating CSP. Materials and methods: A total of 154 patients with CSP and 155 patients with cicatricial uterus termination of pregnancy in the same period who were hospitalized in the Department of Obstetrics and Gynecology, Second Affiliated Hospital of Nanchang University from January 2013 to March 2020 were enrolled in this study. The clinical characteristics of the two groups were statistically analyzed, and CSP patients were divided into the UAE + uterine curettage group (n = 49), MTX + uterine curettage group (n = 33) and uterine curettage alone group (n = 72) according to different treatment methods. The scar thickness, intraoperative blood loss, time to resumption of menstruation and other indicators were compared and analyzed among the three groups. Results: The proportion of CSP patients with cesarean section time &lt; 24 months and ≥ 60 months was significantly higher than that of pregnant women with scar uterus. In the MTX + curettage group, 2 cases had intraoperative blood loss of more than 200 mL where the gestational age was more than 10 weeks, in which they were given Foley’s catheter balloon compression hemostasis. In patients with simple uterine curettage, 6 cases had intraoperative blood loss of more than 200 mL with a gestational age of more than 8 weeks. Two cases were given emergency interventional treatment, while four underwent Foley catheter balloon compression hemostasis. The recovery time of β-hCG in the UAE + curettage group was shortest, which was found to be statistically significant. Furthermore, menopause time, blood β-hCG level and gestational sac diameter were found to be positively correlated with the amount of bleeding, while the thickness of the uterine scar was negatively correlated with the amount of bleeding. Conclusions: Gestational age, blood β-hCG level before treatment, gestational sac diameter and scar thickness were early warning indicators to evaluate the amount of bleeding in the treatment of CSP. UAE OR MTX pretreatment before cesarean section in CSP patients can significantly reduce intraoperative blood loss, and MTX + curettage is safe and effective for patients with abundant blood flow around the gestational sac with a gestational age of 8–10 weeks. However, in regard to CSP patients with a gestational age greater than 10 weeks and rich blood flow around the gestational sac, UAE pretreatment followed by termination of pregnancy is preferred. In case of hemorrhage during uterine curettage, the emergency intrauterine balloon compression can achieves adequate hemostasis.

Osteoma Osteoide de falange. Reporte de cinco casos y revisión bibliográfica

Resumen Introducción: El osteoma osteoide de falange es un cuadro infrecuente. El objetivo de este artículo es presentar cinco pacientes con diagnóstico histopatológico de osteoma osteoide de falange y resaltar los aspectos más relevantes del diagnóstico y el tratamiento. Materiales y Métodos: Estudio descriptivo, retrospectivo. Se evaluaron el dolor, según la escala analógica visual, la movilidad activa y el puntaje QuickDASH antes de la cirugía y en el control final a los 35.4 meses. Resultados: El tiempo medio desde la primera consulta hasta el diagnóstico fue de 10.6 meses (rango 5-16). El puntaje QuickDASH medio preoperatorio fue de 22,72 (rango 6,8-40,9). Luego del seguimiento medio de 35.4 meses (rango 17-63), todos los pacientes estaban satisfechos con el resultado. El puntaje medio de dolor fue 0. El puntaje QuickDASH medio fue 0. Conclusiones: El osteoma osteoide debe pensarse como diagnóstico diferencial ante un paciente que consulta por dolor digital subagudo o crónico que cede con antinflamatorios no esteroides. El tratamiento quirúrgico mediante el curetaje simple o la resección en bloque logra resultados satisfactorios. Sin embargo, como su prevalencia es baja, se suele pasar por alto y así se retrasan el diagnóstico y el tratamiento. Palabras clave: Osteoma osteoide; falange; dedo; dolor crónico; tumefacción. Nivel de Evidencia: IV

The impact of curettage technique on local control in giant cell tumour of bone.

Although consensus has been reached regarding the main aspects of intralesional surgery for giant cell tumour of the bone (GCTB), debates continue about the most effective combination of local adjuvants. The purpose of study was to analyze the previous experience and determine the most effective curettage approach for GCTB. We summarized the findings from 89 papers published from 1962 to 2020 related to this subject. Database consisted of 137 treated groups that included 6441 patients who underwent different curettage techniques without pre-operative administration of bisphosphonates or RANKL inhibitors. Recurrence rates after simple curettage ranged between 27 and 82% with a median value at 47%. The use of one or two local adjuvants reduced the incidence of recurrences approximately by 50% when compared with simple curettage. High-speed burring combined with chemical adjuvants or followed by poly(methyl methacrylate) cementation with or without bone grafting further improved the local control leading to good and excellent results; however, these were not documented in all studies. Simultaneous use of burring, chemical adjuvants, and cementation, which we named here as combined curettage, allowed to down local relapses to the range of 0-26%, with a median at 11%. Oncologic outcomes after combined curettage are significantly better when compared with simple curettage (p < 0.0001) and other variants of enhancement (p = 0.001). Combined curettage appears to provide the most potent and comprehensive impact on residual tumour cells located in risk zones. This approach should be considered for locally advanced tumours when function-preserving surgery is planned. Additional comparative studies are required to define the optimal curettage enhancement for each individual patient.

MANAGEMENT OF ODONTOGENIC MYXOMA OF MANDIBLE BY SEGMENTAL RESECTION – A CASE REPORT

Abstract OdontogenicMyxoma (OM) is a benign odontogenic tumour of ectomesenchymal origin. It presents as a slow growing, painless locally aggressive tumour of jaw bones, common in the posterior mandible and is generally asymptomatic.Treatment in¬cludes surgical management that may range from simple enucleation and curettage to surgical excision in the form of peripheral osteotomy, segmental or radical resection. Here, we present a case report on odontogenicmyxoma of mandible managed by segmental resection. Key words Odontogenicmyxoma – Mandible – segmental resection – reconstruction plate