穿腮腺入路治疗髁突基部斜形骨折的临床研究  

Clinical study of transparotid approach for treatment of condylar base obliqu fractures

作　　者：胡新月[1] 华泽权[1] 王帅[1] 鲍海宏[1] 张力[1] 朱浩[1] 林森[2] 董智伟[1] 

机构地区：[1]沈阳军区总医院口腔颌面外科,辽宁沈阳110840 [2]沈阳军区总医院放射科,辽宁沈阳110840

出　　处：《临床口腔医学杂志》2015年第1期46-48,共3页Journal of Clinical Stomatology

基　　金：辽宁省科技厅科技攻关科研课题(20122255014)

摘　　要：目的:探讨穿腮腺入路治疗髁突基部斜形骨折的手术方法及其疗效。方法:对18例(21侧)髁突基部斜形骨折患者采用腮腺区"S"形切口,穿腮腺入路进行切开复位和内固定术。结果:5例患者前牙开牙合,经颌间牵引2周咬合关系明显改善;8例张口受限,经张口训练术后3个月均恢复正常;3例张口偏斜,术后6个月恢复正常;4例4侧出现面神经损伤症状,其中1例颧支损伤术后1个月恢复正常,3例颊支损伤术后3个月恢复正常。患者均未出现涎瘘,骨折断端对位良好,钛板钛钉固定良好,未见髁突吸收及关节强直现象。结论:采用腮腺区"S"行切口,穿腮腺入路进行切开复位和内固定术是治疗髁突基部斜形骨折的较好方法。Objective：To discuss the therapeutic efficacy of transparotid approach for treatment of condylar base obliqu fractures. Method：18 patients with 21 unilateral condylar base obliqu fractures were treated with transparotid ap-proach to have opening reduction and internal fixateon. Result：5 patients had anterior open bite,and improved obviously af-ter intermaxillary traction for 2 weeks.8 patients had limitation of mouth opening and all recovered in 3 months.3 patients had deviation on opening and all recovered in 6 months.4 patients with 4 unilateral had facial nerve damage,including 1 u-nilateral with zygomatic branch damage which recovered in 1 month and 3 unilateral with buccal branch damage which re-covered in 3 months.Postoperative salivary fistulae was not observed in any patient.All patients had anatomical reduction. Conclusion：Transparotid approach to have opening reduction and internal fixation is a good method to treat condylar base obliqu fractures.

关 键 词：髁突骨折 穿腮腺入路 面神经 

分 类 号：R782.4[医药卫生—口腔医学]