Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts

Utku Mete; Fatih Duman; Özlem Saraydaroglu; Uygar Levent Demir

doi:10.5152/ejra.2024.24149

Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts

Abstract

Objective: Odontogenic cyst surgeries are commonly performed procedures, but they may present challenges with wound healing during the postoperative period. However, insufficient research exists on this topic. This study aimed to determine the risk factors linked to incomplete wound healing after removing a benign odontogenic cyst in the maxilla. Methods: This study involved patients who underwent transoral Caldwell–Luc surgery and endoscopic endonasal surgery to treat benign odontogenic cysts located in the maxilla between 2014 and 2024 at the University Hospital. Investigated risk factors included demographic factors (gender, age), medical history (comorbidities, smoking habits), cyst size, and serum inflammatory markers like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and systemic immune-inflammation index (SII). After 3 months of the postoperative period, patients were classified as either having incomplete or optimal healing. Results: Smoking affected incomplete wound healing (χ² = 6.09, P = .0136). Large cysts are associated with the devel- opment of poor healing (odds ratio (OR) = 7.5, 95% confidence interval (CI) 1.20 to 47.05, P = .0473). Also, high NLR and SII levels were found to be essential factors in suboptimal wound healing (OR = 4.667, 95% CI 0.42 to 52.12, P = .294; OR = 9.1, 95% CI 1.39 to 59.62, P = .037, respectively). Conclusion: This study emphasized the significance of assessing cyst size, smoking status, and inflammatory met- rics like serum NLR and SII before benign odontogenic cyst surgeries. Neutrophil-to-lymphocyte ratio and SII, easily obtained from routine serum tests, may serve as cost-effective prognostic values for wound healing, replacing expen- sive immunological biomarkers.

Keywords

References

Avelar RL, Antunes AA, Carvalho RWF, Bezerra PGCF, Oliveira Neto PJ, Andrade ESS. Odontogenic cysts: a clinicopathological study of 507 cases. J Oral Sci. 2009;51(4):581-586.
Neville BW, Damn DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 3rd ed. Published online; 2002.
Wright JM, Vered M. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: odontogenic and Maxillofacial Bone Tumors. Head Neck Pathol. 2017;11(1):68-77.
Soluk-Tekkesin M, Wright JM. The World Health Organization Classification of Odontogenic Lesions: a summary of the changes of the 2022 (5th) Edition. Turk Patoloji Derg. 2022;38(2):168-184.
Safadi A, Kleinman S, Gigi D, et al. Surgical management of odontogenic cysts involving the maxillary sinus: a retrospective study. J Craniomaxillofac Surg. 2020;48(8):800-807.
Hunter P. The inflammation theory of disease. The growing realization that chronic inflammation is crucial in many diseases opens new avenues for treatment. EMBO Rep. 2012;13(11):968-970.
Wang RH, Wen WX, Jiang ZP, et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front Immunol. 2023;14:1115031.
Howard R, Kanetsky PA, Egan KM. Exploring the prognostic value of the neutrophil-to-lymphocyte ratio in cancer. Sci Rep. 2019;91:1-10.

Li MX, Liu XM, Zhang XF, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer. 2014;134(10):2403-2413.
Wang B, Huang Y, Lin T. Prognostic impact of elevated pre-treatment systemic immune-inflammation index (SII) in hepatocellular carcinoma: a meta-analysis. Med (United States). 2020;99(1):e18571.
Wang Y, Li Y, Chen P, Xu W, Wu Y, Che G. Prognostic value of the pretreatment systemic immune-inflammation index (SII) in patients with non-small cell lung cancer: a meta-analysis. Ann Transl Med. 2019;7(18):433-433.
Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Investig. 2020;50(5):e13230.
Liu J, Ao W, Zhou J, Luo P, Wang Q, Xiang D. The correlation between PLR-NLR and prognosis in acute myocardial infarction. Am J Transl Res. 2021;13(5):4892-4899. Accessed May 13, 2024.
Trifan G, Testai FD. Systemic immune-inflammation (SII) index predicts poor outcome after spontaneous supratentorial intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2020;29(9):105057.
Li S, Liu K, Gao Y, et al. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol. 2020;5(4):368-373.
Białek EJ, Jakubowski W, Karpińska G. Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress. Arch Otolaryngol Head Neck Surg. 2003;129(9):929-933.
Eissa M, Shaarawy S, Abdellateif MS. The role of different inflammatory indices in the diagnosis of Covid-19. Int J Gen Med. 2021;14:7843-7853.
Citu C, Gorun F, Motoc A, et al. The predictive role of NLR, d-NLR, MLR, and SIRI in COVID-19 mortality. Diagnostics (Basel). 2022:122;12(1):122.
Velnar T, Bailey T, Smrkolj V. The wound healing process: an overview of the cellular and molecular mechanisms. J Int Med Res. 2009;37(5):1528-1542.
Ramasastry SS. Acute wounds. Clin Plast Surg. 2005;32(2):195-208.
Zomer HD, Trentin AG. Skin wound healing in humans and mice: challenges in translational research. J Dermatol Sci. 2018;90(1):3-12.
Qian LW, Fourcaudot AB, Yamane K, You T, Chan RK, Leung KP. Exacerbated and prolonged inflammation impairs wound healing and increases scarring. Wound Repair Regen. 2016;24(1):26-34.
Holzer-Geissler JCJ, Schwingenschuh S, Zacharias M, et al. The impact of prolonged inflammation on wound healing. Biomedicines. 2022;10(4).
Lassig AAD, Lindgren BR, Itabiyi R, Joseph AM, Gupta K. Excessive inflammation portends complications: wound cytokines and head and neck surgery outcomes. Laryngoscope. 2019;129(7):E238-E246.
Maruyama Y, Inoue K, Mori K, et al. Neutrophil-lymphocyte ratio and plateletlymphocyte ratio as predictors of wound healing failure in head and neck reconstruction. Acta Otolaryngol. 2017;137(1):106-110.
Morton HJV. Tobacco smoking and pulmonary complications after operation. Lancet. 1944;243(6290):368-370.
Tønnesen H. Surgery and smoking at first and second hand: time to act. Anesthesiology. 2011;115(1):1-3.
Khullar D, Maa J. The impact of smoking on surgical outcomes. J Am Coll Surg. 2012;215(3):418-426.
Vineis P, Alavanja M, Buffler P, et al. Tobacco and cancer: recent epidemiological evidence. J Natl Cancer Inst. 2004;96(2):99-106.
Sørensen LT. Wound healing and infection in surgery: the clinical impact of smoking and Smoking Cessation: A systematic review and meta-analysis. Arch Surg. 2012;147(4):373-383.
Kaylie DM, Bennett ML, Davis B, Jackson CG. Effects of smoking on otologic surgery outcomes. Laryngoscope. 2009;119(7):1384-1390.
Cox MD, Anderson SR, Russell JS, Dornhoffer JL. The impact of smoking on ossiculoplasty outcomes. Otol Neurotol. 2016;37(6):721-727.
Krzeski A, Galewicz A, Chmielewski R, Kisiel M. Influence of cigarette smoking on endoscopic sinus surgery long-term outcomes. Rhinology. 2011;49(5):577- 582.
Das S, Khichi SS, Perakis H, Woodard T, Kountakis SE. Effects of smoking on quality of life following sinus surgery: 4-year follow-up. Laryngoscope. 2009;119(11):2284-2287.
Ghasemi S, Fotouhi A, Moslemi N, Chinipardaz Z, Kolahi J, Paknejad M. Intra and postoperative complications of lateral maxillary sinus augmentation in smokers vs nonsmokers: A systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(4):759–767.
Tonetti MS, Pini‐Prato G, Cortellini P. Effect of cigarette smoking on periodontal healing following GTR in infrabony defects. A preliminary retrospective study. J Clin Periodontol. 1995;22(3):229-234.

Details

Primary Language

English

Subjects

Otorhinolaryngology

Journal Section

Research Article

Authors

Utku Mete
0000-0003-0902-8061
Türkiye

Fatih Duman This is me
0009-0000-7164-2455
Türkiye

Özlem Saraydaroglu This is me
0000-0002-4127-9656
Türkiye

Uygar Levent Demir This is me
0000-0002-9590-1420
Türkiye

Publication Date

December 10, 2024

Submission Date

August 12, 2024

Acceptance Date

October 13, 2024

Published in Issue

Year 2024 Volume: 7 Number: 3

DOI

https://doi.org/10.5152/ejra.2024.24149

IZ

https://izlik.org/JA64BB54HT

Cite

RIS / Bibtex

APA

Mete, U., Duman, F., Saraydaroglu, Ö., & Demir, U. L. (2024). Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts. European Journal of Rhinology and Allergy, 7(3), 95-101. https://doi.org/10.5152/ejra.2024.24149

AMA

1.Mete U, Duman F, Saraydaroglu Ö, Demir UL. Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts. Eur J Rhinol Allergy. 2024;7(3):95-101. doi:10.5152/ejra.2024.24149

Chicago

Mete, Utku, Fatih Duman, Özlem Saraydaroglu, and Uygar Levent Demir. 2024. “Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts”. European Journal of Rhinology and Allergy 7 (3): 95-101. https://doi.org/10.5152/ejra.2024.24149.

EndNote

Mete U, Duman F, Saraydaroglu Ö, Demir UL (December 1, 2024) Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts. European Journal of Rhinology and Allergy 7 3 95–101.

IEEE

[1]U. Mete, F. Duman, Ö. Saraydaroglu, and U. L. Demir, “Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts”, Eur J Rhinol Allergy, vol. 7, no. 3, pp. 95–101, Dec. 2024, doi: 10.5152/ejra.2024.24149.

ISNAD

Mete, Utku - Duman, Fatih - Saraydaroglu, Özlem - Demir, Uygar Levent. “Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts”. European Journal of Rhinology and Allergy 7/3 (December 1, 2024): 95-101. https://doi.org/10.5152/ejra.2024.24149.

JAMA

1.Mete U, Duman F, Saraydaroglu Ö, Demir UL. Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts. Eur J Rhinol Allergy. 2024;7:95–101.

MLA

Mete, Utku, et al. “Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts”. European Journal of Rhinology and Allergy, vol. 7, no. 3, Dec. 2024, pp. 95-101, doi:10.5152/ejra.2024.24149.

Vancouver

1.Utku Mete, Fatih Duman, Özlem Saraydaroglu, Uygar Levent Demir. Risk Factors for Wound Healing After Surgical Removal of Maxillary Odontogenic Cysts. Eur J Rhinol Allergy. 2024 Dec. 1;7(3):95-101. doi:10.5152/ejra.2024.24149