牵引成骨技术在颞下颌关节强直重建治疗中的临床研究  

Distraction Osteoporosis for the Treatment of Temporomandibular Joint Ankylosis

作　　者：李阳 刘樱 王吉 曲卫国 曲哲 王颖 马卫东 

机构地区：[1]大连市口腔医院口腔颌面外科,辽宁大连116021 [2]大连市口腔医院八一路门诊部

出　　处：《口腔医学研究》2013年第9期842-844,共3页Journal of Oral Science Research

摘　　要：目的：探讨牵引成骨技术在颞下颌关节强直治疗中的应用。方法：2006年7月～2011年7月大连市口腔医院颌面外科收治例颞下颌关节强直病例6例，均伴有不同程度的阻塞性睡眠呼吸暂停低通气综合征。18～27岁女性患者均为单侧骨性强直，术前开口度0．5～1．0cm，术中安装下颌骨内置式牵引器，术后1周开始骨牵引。所有患者采用牵引成骨关节成形术治疗，通过测量开口度及牵开长度观察其疗效，并观察并发症情况及阻塞性睡眠呼吸暂停低通气综合征症状改善情况，随访观察6个月～2年。结果：6例患者均完成治疗进入结果分析。6例患者牵开长度30～32mm，平均31mm。开口度由术前平均7．5mm提高到术后平均3imm，开闭口运动正常。随访6个月～2年后，开口度平均38mm，成骨良好，术后3个月X射线片检查及创口内检查均证实骨质形成良好。所有患者无明显并发症出现。阻塞性睡眠呼吸暂停低通气综合征症状缓解明显，术前每例患者均有睡眠打鼾症状，术后均有缓解。结论：牵引成骨术治疗颞下颌关节强直具有手术简单，风险小，治疗效果确实可靠，复发率低等优点，同期还可以治疗颌骨发育不足导致的睡眠呼吸暂停低通气综合征。Objective： To observe the curative effect of distraction osteoporosis on temporomandibular joint ankylo sis. Methods： Six patients with temporomandibular joint ankylosis and obstructive sleep apnea（OSA）admitted by Dalian Hospital of Stomatology were selected from July 2006 to 2011. All patients were treated by distraction osteo porosis and the curative effect was observed by the measurement of incision and distraction length. Meanwhile,the complications and the improvement in OSA and bypopnea syndrome（OSAHS）were observed. Results： All 6 pa- tients were included in the final analysis. The lowest distraction length was 30mm and the highest was 32mm with the average length of 31 ram. The mouth opening was increased from pre--operative 7. 5mm to post--operative 31ram. Follow-up 6month-2years, the mouth opening was 38ram. Bone formation was good , and the X--ray films and wound examination indicated the sclerotized was good. No obvious complication was found in all patients with infection,neutral injury , distractor defluxion or breakage. No relapse was found. OSAHS was improved signif- icantly. Conclusion： The distraction osteoporosis in the treatment of temporomandibular joint ankylosis presents many advantages, for example the simple operation, the lower risk, the confessed curative effects and the lower re lapse rate. At the same time, it can cure the OSAHS caused by maxillary deficiency.

关 键 词：牵引成骨 颞下颌关节强直 并发症 组织构建 

分 类 号：R782.6[医药卫生—口腔医学]