颧上颌骨骨折手术治疗的临床研究  

Clinical study on operation treatment of zygomatic maxillary fracture

作　　者：师俊莉[1] 刘淑妍[1] 薛萍[1] 张曦[1] 何林[1] 舒茂国[1] 

机构地区：[1]第四军医大学西京医院全军整形外科研究所,陕西西安710032

出　　处：《中国美容整形外科杂志》2014年第11期657-659,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的：回顾采用半冠状切口、睑下缘切口、口内前庭沟切口以及局部小切口入路治疗颧上颌骨骨折的临床效果,并观察并发症的发生情况。方法手术入路采用半冠状切口或局部小切口、睑下缘切口、口内前庭沟切口,直视下对其进行松解、复位、钛板固定,并评价临床效果及术后并发症的发生情况。结果所有患者咬牙合关系及张口度好,面部形态对称良好。1例出现面神经额支损伤,11例瘢痕明显,3例头额顶区疼痛、麻木,1例出现颞部凹陷,8例出现下睑淤血、结膜充血,1例下睑外翻,2例下睑凹陷。结论头皮半冠状切口及局部小切口、睑下缘切口及口内前庭切口是颧上颌骨骨折最常用的手术入路,在熟练掌握手术入路及骨折固定原则的基础上,绝大多数的患者均能获得良好的效果,但仍有少数患者可能出现并发症。术中应注重局部的解剖关系,掌握相关的固定原则,重视操作技巧,尽量避免并发症的发生。Objective To investigate the clinical treatment efficacy and the complications of the semi-coronal incision,lower eyelid incision and oral vestibular groove incision for zygomatic maxillary fracture.Methods The semi coronal incision,the lower edge of eyelid incision and oral vestibular groove incision were adopted,76 patients with maxillary zygomatic fracture were corrected by loosened,reposition and fixation with mini titanium plate under direct vision.The clinical effects and complications were analyzed retrospectively.Results All cases healed pri-marily,and all patients were satisfied with occlusion and good mouth opening.Some cases were with some compli-cations including frontal branch of facial nerve permanent damaged in 1case,obvious scar in 11 cases,frontal parietal region pain and numbness in 3 cases,temporal depression was identified in 1 cases,lower eyelid congestion and conjunctival hyperemia in 8 cases,lower eyelid ectropion in 1 case and lower eyelid depression in 2 cases. Conclusion Semi-coronal incision and local small incision eyelid under the edge of the incision and intraoral vestib-ular incision is the most common surgical approach in zygomatic maxillary fractures.The vast majority of patients can have a good therapeutic efficacy on the basis of surgical approaches and fractures principles,but some possible complications may take place.Complications will be avoid if we focus on the local anatomical relationships during the operation,master the concerned principle of fixation and take emphasis on the operating skills.

关 键 词：颧上颌骨骨折 手术入路 并发症 

分 类 号：R782.2[医药卫生—口腔医学]