Artikel
Intracranial Ameloblastoma arising from the maxilla: an interdisciplinary surgical approach
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only few cases are known to grow aggressively and to invade the orbit, nasal cavity or even the brain.
Method: We hereby present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the let maxilla and the anterior fossa. Histological diagnosis was made by biopsy. In a next step a combined, two staged neurosurgical-maxillo-facial approach was planned.
Results: First the intracranial tumor mass was removed by using a bifrontal trepanation. A dura plastic was sewn in to cover the brain. In a second procedure a combined bifrontal and midfacial approach was used by craniofacial-plastic-surgeons and neurosurgeons. Parasinusoidal tumor mass and retropharyngeal tumor mass was removed until reaching the skull base. The left orbit was completely exonerated and a fibular bone-muscle graft was used for palatinal, orbital and facial reconstruction. Facial vein and artery were carefully prepared to feed the bone-muscle graft by end-to-end anastomoses.
Conclusions: Ameloblastomas are very rare tumors which are slowly growing but show a tendency to recur. They are responsible for only 1% of all oral tumors. Their growth can be enormous and they can extend into sinusoidal cavities, the orbit and the brain. Complex and extensive surgery as a palliative setting can ease complaints of these patients and prolong their survival.