Marsupialisation for keratocystic odontogenic tumours in the mandible: longitudinal image analysis of tumour size using 3D visualised CT scans

• Published in: International journal of oral and maxillofacial surgery Vol. 41; no. 3; pp. 290 - 296
• Main Authors: Shudou, H, Sasaki, M, Yamashiro, T, Tsunomachi, S, Takenoshita, Y, Kubota, Y, Ninomiya, T, Kawazu, T, Mori, Y
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-03-2012; Elsevier
• Subjects: Adolescent; Adult; Algorithms; Biological and medical sciences; Curettage; Debridement; decompression; Decompression, Surgical; Dentistry; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; keratocystic odontogenic tumour; Longitudinal Studies; Male; Mandible - diagnostic imaging; Mandible - surgery; Mandibular Neoplasms - diagnostic imaging; Mandibular Neoplasms - surgery; marsupialisation; Medical sciences; Middle Aged; Odontogenic Tumors - diagnostic imaging; Odontogenic Tumors - surgery; Osteogenesis - physiology; Otorhinolaryngology. Stomatology; Surgery; Time Factors; Tomography, X-Ray Computed - methods; Wound Healing - physiology; Young Adult; marsupialisation; decompression; keratocystic odontogenic tumour; Mandible; Radiodiagnosis; Stomatology; Size; Image analysis; Treatment; Odontogenic tumor; Follow up study; Surgery; Medical imagery; Computerized axial tomography
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2011.10.015

Abstract The purpose of this study was to determine how keratocystic odontogenic tumours (KCOTs) in the mandible are reduced during marsupialisation, and to predict the best time for secondary enucleation by analysing computed tomography (CT) images. 15 patients with KCOTs were treated with marsupialisation surgery, and 42 series of CT data taken during the marsupialisation process were analysed. CT data were reconstructed in three-dimensional (3D) images. The 3D images were used to measure the diameter and volume, and to analyse the changes that occurred after marsupialisation. Marsupialised KCOTs tended to be reduced equally towards the window in the tumour. The amount of volume reduction per day ( Vr ) was reduced in proportion to the volume ( V ) with the formula Vr = −0.0029 × V . The formula manipulation for V was V = V0 × e −0.0029 t ( t = duration after marsupialisaton (day)). The volume of marsupialised KCOTs was reduced by half over a 239 day cycle. These results demonstrate that the future shape of marsupialised mandibular KCOTs, under good control, could be predicted with significant accuracy using CT data. This prediction could decrease the prolonged marsupialisation state in patients with KCOTs.