Surgical Difficulties of Ramus Lesions

Abstract

The mandible ramus lesions are more difficult to access in surgical procedures than mandible corpus lesions because of surrounding vital tissues of the mandible ramus. In our study, 22 patients with cysts and tumors who were treated between the years 2000-2011 at Suleyman Demirel University, Faculty of Dentistry, Oral and Maxillofacial Surgery Department, were examined prospectively in terms of transportation difficulties mandible ramus . 19 patients were treated with enucleation and curettage, enucleation was applied after the marsupialization and decompression treatment to the two patient. One patient was treated with partial resection because of the Ameloblastoma . Nerve damage after the surgery was identified as the most common complication in patients. In located ramus of lesions, utilization of the tomographic imaging methods and very good knowledge of the anatomical structure of the region or at least used a hand tool, make the process more convenient .

Keywords

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MANDİBULER RAMUS LEZYONLARININ CERRAHİ ZORLUKLARI

Abstract

Amaç Çevresindeki vital dokular nedeniyle mandibula ramusuna yerleşmiş lezyonlara erişmek, mandibula korpusundaki lezyonlara ulaşmaktan daha zordur. Çalışmamızda Süleyman Demirel Üniversitesi Diş Hekimliği Fakültesi Ağız Diş Çene Hastalıkları ve Cerrahisi Ana Bilim Dalı'nda 2000-2011 yılları arasında tedavi edilen 22 kist ve tümör hastası ramusa ulaşım zorlukları açısından prospektif olarak incelenmiştir. Yöntem 19 hastaya enükleasyon ve küretaj uygulanırken iki hastaya marsüpyalizasyon ve dekompresyon uygulamasının ardından enükleasyon uygulanmıştır. Bir hasta ise ameloblastoma nedeniyle parsiyel rezeksiyonla tedavi edilmiştir. Sonuç Hastalarda en sık görülen komplikasyon sinir hasarı olarak belirlenmiştir. Ramus bölgesine yerleşmiş lezyonlarda, tomografik görüntüleme yöntemlerinden faydalanılması, bölgenin anatomik olarak çok iyi bilinmesi, insizyon ve giriş için kullanılacak işaret noktalarının direkt görülerek, palpe edilerek ya da en azından bir el aleti yardımıyla belirlenerek işlemin yapılması daha uygundur.

Keywords

• Ramus, alt çene, küretaj, kist, ameloblastoma

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