改良头皮冠状切口在颧骨复合体骨折中的应用  

A Modified Temporal Coronal Incision:an Alternative Approach to Zygomatic Complex

作　　者：彭布强 高振杰[1] 申露露[1] 郝保平[1] 蔡明河 

机构地区：[1]河南宏力医院口腔颌面外科,河南新乡453400

出　　处：《口腔颌面外科杂志》2014年第4期285-288,共4页Journal of Oral and Maxillofacial Surgery

摘　　要：目的：探讨改良头皮冠状切口在各类颧骨复合体骨折坚固内固定术中的应用。方法：将87例颧骨复合体骨折病例分为改良组和传统组,分别应用改良冠状切口（42例）与传统切口（45例）进行复位和固定,对比分析改良冠状切口的优越性、可能并发症及预防措施。结果：改良组切口均Ⅰ期愈合,随访3~6个月,面部瘢痕不明显,开口度恢复理想,咬合关系正常,术后秃发率及颞部凹陷率较低,无1例出现面神经功能障碍。传统组中,2例术后第5天出现创区感染,切口延期愈合,术后肿胀反应明显;4例患者术后3月时仍存在面神经功能障碍,术后秃发率及颞部凹陷率较高。结论：改良冠状切口较传统切口具有切口隐蔽、术野暴露好、复位精确、美观效果好、面神经损伤率低等优点,值得推广应用。Objective： To summarize the effects of a modified coronal incision in treating various zygomatic complex fractures （ZCF）. Methods： 87 patients with zygomatic complex fractures were divided into two groups in the light of incision sites, which were conventional incision group（n=45） and modified coronal incision group（n=42）. Operative procedures including open reduction and internal rigid fixation were performed. The advantages, potential complications and preventive measures were analysed and compared. Results： In the modified incision cases, healing with first intention achieved in all patients. After 3-6 months follow-up, the scars were not obvious, mouth opening and occlusion were greatly improved,function of facial nerves were all normal. In the conventional incision cases, 2 patients showed postoperative infection, 4 patients still had damaged facial nerve function until 3 months postoperation. The proportion of alopecia and depression of temporal region were high in conventional incision group. Conclusion： The modified temporal coronal incision demonstrated a concealment, better exposured, accurate repositioned, and satisfactory both in appearance and functions benefits.

关 键 词：改良冠状切口 颧骨复合体骨折 坚固内固定 面神经 腮腺上极 颞筋膜 

分 类 号：R782.4[医药卫生—口腔医学]