Conservative Surgical Management of Ameloblastoma Amongst 63 Patients in Enugu, Nigeria: A 12-Year Evaluation of Clinical Outcome

Objectives: Ameloblastoma is benign but an aggressive tumour of epithelial origin that is known for its high rate of recurrence after surgical removal necessitating a radical surgical approach. The aim of this study was to highlight the clinical outcome of conservative surgical procedure amongst the 63 patients treated in Enugu, eastern Nigeria.

Patients and Method: We carried out a post-surgical clinical evaluation of 63 cases of ameloblastoma treated under conservative surgical procedure in three specialist hospitals in eastern Nigeria over a 12-year period from January 2007 to December 2018. These patients were referred to the units by the dental surgeons, medical practitioners, and health centres in the catchment areas of the hospitals in eastern Nigeria. The age range was between 13 and 56 years (Mean 32 + 5.8 SD). The standard conservative surgical procedure was the same in all cases and was performed by the same surgeons. We categorized the cases by the size, site of the tumour, sex and age of the patients, and radiological presentation.

Results: Of the 63 cases treated, there were 28 male (44%) and 35 female (56%) patients, giving a male-to-female ratio of 1:1.3. All the patients had satisfying postoperative aesthetic outcome and quality of life. Out of the Eight (13%) cases which showed recurrence, three (37%) underwent second conservative procedure, while marginal resection was carried out also in three (37%) patients. Two (26%) of the patients had total mandibulectomy after 10 years for lack of follow-up.

Conclusion: Our experience with the conservative surgical procedure of ameloblastoma when presented early in younger adults shows minimal recurrence rate. Since this presents a better esthetic and clinical outcome, there is a need for proper evaluation of treatment approaches to ameloblastoma through multiple center collaborations and professional interactions across the globe.