改良耳屏前切口解剖面神经颧颞支径路行髁状突骨折复位内固定术的临床研究  

Clinical research of rigid internal fixation on mandibular condylar fractures using improved incision before tragus and dissection of the facial nerve zygomatic and temporal branch

作　　者：唐丽宇[1] 张敏[1] 齐李平[1] 朱晓东[1] 庄劭玉[1] 龚飞飞[1] 

机构地区：[1]东南大学医学院附属马鞍山市人民医院口腔科,安徽马鞍山243000

出　　处：《东南大学学报（医学版）》2011年第3期503-505,共3页Journal of Southeast University(Medical Science Edition)

基　　金：马鞍山市科技局科技计划资助项目(2009C14)

摘　　要：目的:探讨改良耳屏前切口解剖面神经颧颞支径路进行髁状突骨折复位内固定手术的临床疗效。方法:选择髁状突骨折PDA分类Ⅰ、Ⅲ型患者8例,采用改良耳屏前切口,解剖腮腺,寻及面神经颧颞支,在两神经支之间通过破损的关节囊进行髁状突骨折复位内固定。术后1、3、6个月进行临床和影像学检查,分析疗效。结果:本组8例患者伤口全部Ⅰ期愈合,面部对称,局部瘢痕不明显。随访时间1～6个月,1例术后轻度面瘫,3个月后恢复正常。1个月内都有张口疼痛,但3个月内疼痛均逐渐缓解。咬合关系恢复良好,张口度均在2.5～3.0 cm。术后1、3、6个月复查全景片或CT见骨折生长良好。结论:改良耳屏前切口解剖面神经颧颞支径路可以良好地暴露术野,对于适合的病例进行复位内固定可以取得良好疗效。Objective： To investigate the clinical effect of rigid internal fixation on mandibular condylar ft-actures using improved incision before tragus and dissection of the facial nerve zygomatic and temporal branch. Methods： Eight cases of mandibular condylar fracture PDA Ⅰ ,Ⅲ were treated with improved incision before tragus. After dissecting of the fa- cial nerve zygomatie and temporal branch, we found the broken joint capsule and fixed on mandibular condylar fractures between the two branches. Clinical and imaging examinations were taken in 1, 3 and 6 months after operation to analysis of efficacy. Results： All of the patients were Ⅰ wound healing. Local scars were not obvious. Following-up 1 month to 6 months,we only found one patient oecured mild facial paralysis and returned to normal after 3 months. Eight patients all felt pain when open mouth within one month, but everyone could ease the pain within 3 month. Occlusion recovered well and mouth opening were 2.5-3.0 era. By the imaging exams,we found fractures grew well after 1,3,6 months. Conclusion： The operative field can be well exposed through this kind of operation approach. Using rigid internal fixation forsuitable cases can achieve good effect.

关 键 词：髁状突骨折 面神经 内固定技术 

分 类 号：R683[医药卫生—骨科学]