改良耳屏切口颞下颌关节盘复位固定术手术入路介绍及效果评价  

A modified tragus incision with vascular-guided multilayer approach to temporomandibular joint

作　　者：焦子先[1] 王翔宇[1] 张晓虎[1] 杨驰[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔外科,上海市口腔医学重点实验室,上海市口腔医学研究所,国家口腔疾病临床研究中心,上海200011

出　　处：《中国口腔颌面外科杂志》2018年第1期41-43,共3页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市卫生与计划生育委员会科研课题(20134148)

摘　　要：目的 :介绍一种改良耳屏切口颞下颌关节盘复位固定术术式并初步评价其临床效果。方法 :选取符合条件的颞下颌关节盘不可复性前移位患者6例(7侧关节),依据Wilkes-Bronstein分期,纳入Ⅳ~Ⅴ期患者,采用改良耳屏切口行颞下颌关节盘复位固定术。结果:术中术区视野显露充分,术后MRI显示全部7侧关节盘复位良好,面神经功能保存良好。结论:经改良耳屏切口行颞下颌关节盘复位固定术,术中暴露关节区充分,术后短期疗效可靠,且具有切口美观,手术创伤小,面神经受损程度轻等优点。可作为颞下颌关节手术的入路之一。PURPOSE： To introduce a modified surgical approach for treating temporomandibular joint （TMJ） disc displacement using tragus incision with vascular-guided multilayer approach and evaluate its clinical outcome. METHODS： Six patients （7 joints） were selected in this study. All patients were diagnosed as stage IV-V of TMJ internal derangement according to Wilkes-Bronstein staging system. All patients underwent open surgery for TMJ disc repositioning and fixation using the modified tragus incision with vascular-guided multilayer approach. TMJ MRI was performed 4 days postoperatively. RESULTS： Good surgical field exposure was obtained and TMJ disc were well replaced in all operations. Postoperative MRI showed satisfactory position of the TMJ disc. The function of facial nerve was well preserved in all patients. CONCLUSIONS： The modified tragus incision with vascular-guided multilayer approach is one of the ideal methods for TMJ open surgery to treat anterior disc displacement.

关 键 词：颞下颌关节 耳屏切口 手术入路 

分 类 号：R782.6[医药卫生—口腔医学]