头皮冠状切口在面中份骨折治疗中的应用分析  

Application foreground of scalp coronal incision in treatment of mid-face fractures

作　　者：谢家敏[1] 武和明[2] 刘延峰[1] 吕春华[1] 

机构地区：[1]江苏省泰州市人民医院口腔颌面外科,泰州225300 [2]南京医科大学口腔医学院口腔颌面外科,南京210029

出　　处：《口腔医学》2012年第4期203-205,216,共4页Stomatology

基　　金：南通大学医学院临床科研项目

摘　　要：目的探讨采用头皮冠状切口治疗面中份骨折的手术适应证、手术方法及并发症的预防措施。方法收集112例面中份骨折病例,采用头皮冠状切口行骨折的复位固定,对伴有眶底骨折出现眼球内陷的病例加用下睑缘切口行眶底重建,对伴有上颌骨骨折病例加用龈颊沟辅助切口。结果采用头皮冠状切口手术,切口隐蔽,术区暴露充分,术野清晰,骨折复位准确,固定可靠。112例病例中,术后咬合关系及张口度恢复良好,有2例出现面神经额支损伤,随访1年未恢复。1例患者术后4 h出现头皮下血肿。5例患者切口缘有部分脱发现象。3例患者耳前出现带状瘢痕。15例诉头皮额顶区疼痛、麻木和感觉不适。2例患者眶下区出现钛板排异反应,术后6个月取出钛板后,反应消失。1例患者出现颞上窝凹陷,钛板取出术时行局部整复,效果满意。3例患者术后患侧显膨隆,钛板取出后,效果满意。所有患者均未发生切口感染。结论对面中份骨折的治疗,头皮冠状切口是一个良好的手术入路,具有切口隐蔽、暴露充分、术野清楚、复位准确、固定可靠、并发症可控等优点。Objective To investigate the surgical indications,operation methods and complications of the application of the scalp coronal incision in the treatment of the mid-face fractures.Methods 112 mid-face fracture cases were treated with scalp coronal incision.Cases accompanied with orbital fracture and enophthalmos were appended with under eyelid incision for orbital floor reconstruction.Cases accompanied with maxillary bone fractures were appended with the upper gingiva buccal ditch auxiliary incision.The treatment effects of all cases were analyzed.Results The use of scalp coronal incision had not only hidden incision,finely exposed surgical site,accurate restoration and reliably fixation.Jaw relation and mouth open degree of all cases were finely recovered.Among the 112 casess,2 cases had symptoms of facial nerve injury,1 case had scalp hematoncus,5 cases had baldness,3 cases had scar in front of the ears,15 patients felt pain and numb at forehead of scalp,2 patients had titanium plate rejection in suborbital area,and 1 patient had temporal fossa sag.Nobody had incision infection.Conclusions For the treatment of the mid-face fractures,the scalp coronal incision is a good way of surgical incision and has a few of advantages like concealed incision,fully exposed clear operative field,accurate restoration,reliable fixation,and controllable complications,etc.Therefore,the scalp coronal incision is a good selection for the treatment of the mid-face fractures.

关 键 词：头皮冠状切口 面中份骨折 并发症 

分 类 号：R782.4[医药卫生—口腔医学]