| 堵梦雨,宋飞翔,张令达.不同类型下颌骨髁突骨折手术治疗的疗效分析[J].安徽医药,2018,22(11):2116-2118. |
| 不同类型下颌骨髁突骨折手术治疗的疗效分析 |
| Efficacy of surgical treatment for different types of mandibular condyle fractures |
| 投稿时间：2017-10-09 |
| DOI： |
| 中文关键词: 髁突骨折 手术入路 坚强内固定 并发症 |
| 英文关键词: Condylar fracture Surgical approach Rigid internal fixation Complications |
| 基金项目:安徽省科技厅科学基金项目(1704f0804023) |
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| 中文摘要: |
| 目的 通过对不同类型下颌骨髁突骨折手术方式选择、术后随访及相关并发症等分析,以期为髁突骨折临床治疗提供一定参考。 方法 收集2014年9月至2016年9月安徽医科大学第一附属医院口腔颌面外科接受治疗的髁突骨折病例22例(共24侧),术中采用耳屏前切口,颌后切口,应用长螺钉,微型钛板固定或直接游离摘除脱位的髁突头,行颞下颌关节重建。术后1个月、3个月、6个月、12个月随访,拍摄X线片或CT,对患者术后愈合情况、开口功能恢复、颞下颌关节及面神经症状等情况进行分析评价。结果(1)22例患者经手术治疗后,面部对称性、咬合功能及解剖结构稳定性均较术前有明显改善；(2)患者术前平均张口度(18.1±3.31) mm,术后复查张口度(37.4±2.89) mm,改善明显,差异有统计学意义(t=-20.16,P＜0.001)；(3)5例患者术后出现面神经损伤症状,其中高位骨折出现1例颧支功能障碍；中位骨折3例(颧支2例,颊支+颧支1例)；低位骨折1例,为下颌缘支；5例患者面神经损伤均为暂时性,通过口服药物,3个月内面神经功能均得到恢复。结论针对不同髁突骨折类型选择合适的手术方式能够获得良好的效果。 |
| 英文摘要: |
| Objective To provide a reference for the clinical treatment of condylar fracture by analyzing the selection of surgical procedures,postoperative follow-up and related complications of different types of mandibular condylar fractures.Methods The clinical data of 22 cases (24 sides) of condylar fractures undergoing oral and maxillofacial surgery in the Department of Oral and Maxillofacial Surgery from September 2014 to September 2016,the First Affiliated Hospital of Anhui Medical University in the past two years were collected.The reconstruction of temporomandibular joint was done by using pre-tragal and post-jaw incisions,fixation with long screws and titanium microplate or direct removal of the dislocated condylar head.Follow-up was conducted at 1,3,6 and 12 months after surgery.An X-ray or a CT scan was taken to analyze and evaluate post-operative healing,function recovery of the cutting,function of facial nerve and temporomandibular joint during the follow-up period.Results (1) The facial symmetry,occlusal function and anatomic stability of all patients were significantly improved after operation.(2) The mean preoperative opening was (18.1±3.31) mm,and the mean follow-up opening was (37.4±2.89) mm which improved obviously and the difference was statistically significant (t=-20.16,P＜0.001).(3) Five patients had facial nerve injury after operation,including a case of high position fracture with zygomatic nerve dysfunction,3 cases of middle position fracture (2 cases of zygomatic nerve dysfunction,1 case of zygomatic and buccal nerve dysfunction) and one case of low position fracture with submandibular nerve dysfunction.The facial nerve injuries were temporary in all 5 patients and were recovered within three months by oral administration of medications.Conclusion Appropriate selection of respective surgical procedures for different types of condylar fractures can achieve satisfactory results. |
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