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題 名 | Determining the Extent of Gingival Squamous Cell Carcinoma Bone Invasion with CBCT--A Case Report=錐狀射源電腦斷層判斷牙齦鱗狀細胞癌骨侵犯範圍--病例報告 |
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作 者 | 李愷忻; 陳孟延; 黃則達; 黃振勳; 王東堯; 陳畊仲; | 書刊名 | 臺灣口腔顎面外科學會雜誌 |
卷 期 | 29:3 2018.09[民107.09] |
頁 次 | 頁218-229 |
分類號 | 416.89 |
關鍵詞 | 口腔鱗狀上皮細胞癌; 骨侵犯; 錐狀射源電腦斷層; Oral squamous cell carcinoma; Bone invasion; CBCT; |
語 文 | 英文(English) |
中文摘要 | 口腔內發生之鱗狀上皮細胞癌,其顎骨侵犯之有無對病人是一重要之預後因子,術前的精確診斷可決定腫瘤切除範園。然而現今並沒有明確共識需使用哪種診斷工具偵測顎骨侵犯與否及其範園。本病例為一位下齒齦鱗狀上皮細胞癌病患,除了傳統電腦斷層,也拍攝錐狀射源電腦斷層。後者在影像學上顯示較前者有更大範圍的顎骨侵犯,清楚呈現膨大之下顎齒槽神經管及骨破壞。因此,我們更改切除範園,由一開始計畫之保留左側髁頭及下顎骨角,擴大為單倒下顎骨切除。也因此術後病理按查達到足夠的安全範圍。文獻研究證實錐狀射源電腦斷層於顎骨侵犯判定有較佳準確性,而本病例確實有助於診斷及手術範圍的規劃。 |
英文摘要 | Bone tissue invasion is a prognostic factor for patients with oral squamous cell carcinoma (OSCC). Detection before an operation may lead to a different surgical plan. To date, there is still no consensus for an adequate tool for determination. In the presented case, we additionally used cone-beam computed tomography (CBCT) as a pre-operative assessment for a patient suffering from left lower gingival SCc. The CBCT image revealed a more distinct bone invasion of the tumor through the inferior alveolar canal compared to the computed tomography image in the view of bone window. This resulted in shifting the surgery to a left hemimandibulectomy instead of preserving the condyle and mandible angle as initially planned. Better accuracy of CBCT for a bone invasion evaluation has been proven in several studies. We believe that CBCT is an adequate tool for bone invasion detection for OSCC patients that provides better accuracy, lower cost, and is feasible in most institutions. |
本系統中英文摘要資訊取自各篇刊載內容。