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      Correlación entre los hallazgos de la biopsia intraoperatoria y el estudio histopatológico definitivo en el tratamiento quirúrgico de los queratoquistes Translated title: Correlation between histopathological findings in intraoperative frozen section biopsy and postoperative biopsy in surgical treatment of keratocyst

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          Abstract

          RESUMEN Objetivo: El queratoquiste (QTQ) es una lesión intraósea benigna que afecta los maxilares. Algunos autores han propuesto utilizar la biopsia rápida intraoperatoria (BRI) como herramienta para orientar el manejo de estas lesiones en una sola intervención quirúrgica, disminuyendo el tiempo total y los costes asociados al tratamiento. El propósito de este trabajo fue evaluar la correlación entre los hallazgos de la BRI y el informe histopatológico definitivo en lesiones quísticas de los maxilares que presentan hallazgos sugerentes a QTQ. Pacientes y métodos: Se realizó un estudio prospectivo de cohorte no concurrente en nuestra institución, que incluyó a todos los pacientes sometidos a enucleación quirúrgica de lesiones de los maxilares, donde se haya realizado una BRI por sospecha de QTQ, entre julio del 2011 y diciembre del 2018. Resultados: Un total de 22 pacientes requirieron BRI por sospecha de QTQ. El diagnóstico histopatológico definitivo, posteriormente de la enucleación de la lesión en estudio, fue de QTQ en 11 casos (50 %), de los cuales 10 casos (90,9 %) fueron clasificados como QTQ según la BRI. La sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo del diagnóstico histopatológico mediante BRI, cuando se compara con los hallazgos histológicos definitivos de una biopsia postoperatoria, fueron 91 %, 100 %, 100 % y 92 %, respectivamente. Conclusión: Es posible sugerir que existe una correlación considerable entre los hallazgos de la BRI y el informe histopatológico definitivo de QTQs. La BRI puede ser un complemento de utilidad durante el tratamiento de lesiones quísticas con signos sugerentes de QTQ, en una sola intervención quirúrgica.

          Translated abstract

          ABSTRACT Purpose: Odontogenic keratocyst (OKC) is a benign intraosseous lesion of the jaws. Management of these lesions includes enucleation and surface treatment, which ensures less recurrence. Some authors have proposed the use of fast intraoperatory biopsy (or frozen section biopsy (FSB)) as a tool to guide the management of this type of lesions in just one procedure thus reducing treatment period and associated costs. The purpose of this study was to assess the correlation between findings of intraoperative FSB and those of deferred histopathological reports of cystic jaw lesions with findings suggesting OKC. Methods: A descriptive retrospective study was performed at the Surgical Oncology and Maxillofacial Surgery Department of all patients undergoing enucleation of jaw lesions with FSB performed due to suspicion of OKC in the period July 2011 to December 2018. Results: A total of 22 patients required FSB due to suspicion of OKC. The final histopathological diagnosis, after enucleation of the cystic lesion, was OKC in 11 cases (50 %), 10 cases of which (90.9 %) were classified as OKC according to the FSB. When compared to histological findings of a postoperative biopsy analysis, sensitivity, specificity, positive predictive value, and negative predictive value of the histopathological diagnosis using FSB were 91 %, 100 %, 100 %, and 92 % respectively. Conclusion: It is possible to suggest that there is a considerable correlation between FSB findings and the final histopathological study of OKC. FSB can be a useful complement in treating cystic jaw lesions with clinical signs suggesting OKC in just one surgery.

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          The Measurement of Observer Agreement for Categorical Data

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            Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odontogenic and Maxillofacial Bone Tumors.

            The 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January of 2017. This article provides a summary of the changes to Chapter 4 Tumours of the oral cavity and mobile tongue and Chapter 8 Odontogenic and maxillofacial bone tumours. Odontogenic cysts which were eliminated from the 3rd 2005 edition were included in the 4th edition as well as other unique allied conditons of the jaws. Many new tumors published since 2005 have been included in the 2017 classification.
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              Odontogenic keratocyst: Review of 256 cases for recurrence and clinicopathologic parameters.

              Odontogenic keratocyst (OKC) is of particular interest because of its high recurrence rate and aggressive behavior. Two hundred fifty-six cases of OKC were reviewed for the age of the patient at diagnosis, sex of the patient, OKC location, and radiographic findings, and 132 patients with OKC were observed to estimate recurrence, which was analyzed for age, sex, location, and several histopathologic findings. OKCs occurred more frequently in men (58.6%) than in women (41.4%), and they occurred in patients within a wide age range, most commonly in patients in the third decade of life (28.9%), followed by those in the second decade (25.0%); the mean age of patients with OKC was 30.8 years. One hundred ninety-six of the 256 cases (76.5%) occurred in the mandible, and the other 60 cases (23.5%) occurred in the maxilla. The mandibular molar and the premolar areas (51.2%) were the most common sites, and the most frequent clinical manifestations at first admission were swelling, pain, or both (82.4% of total cases). Radiographic impressions included dentigerous cyst (27.3%), OKC (25.4%), primordial cyst (14.8%), ameloblastoma (11.7%), residual cyst (9.8%), and radicular cyst (3.1%). The frequency of recurrence at the follow-up examination was 58.3%. There was no significant difference in the recurrence rate on the basis of the sex of the patient. However, OKCs had a significantly higher recurrence rate in patients in the fifth decade of life than in patients in the other age groups (P = .005).Recurrence rates were significantly dependent on the sites of involvement, and OKCs in the mandibular molar region had significantly higher recurrence rates than those in other sites (P = .001). The histopathologic presence of one or more daughter cysts was significantly related to recurrence (P = .03).
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                December 2021
                : 43
                : 4
                : 149-155
                Affiliations
                [1] Santiago Santiago de Chile orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Departamento de Cirugía Oncológica y Maxilofacial Chile
                [4] Santiago Santiago de Chile orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Departamento de Anatomía Patológica Chile
                [3] Santiago Santiago de Chile orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Cirugía Maxilofacial Chile
                [2] Santiago Santiago de Chile orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina Chile
                Article
                S1130-05582021000400005 S1130-0558(21)04300400005
                10.20986/recom.2021.1304/2021
                8ddd00d6-77a7-431c-aa5d-dc95f7323e67

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 10 August 2021
                : 18 November 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 7
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                SciELO Spain

                Categories
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                intraoperative biopsy,frozen section biopsy,keratocyst,Odontogenic cysts,biopsia intraoperatoria,biopsia por congelación,queratoquiste,Quistes odontogénicos

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