下颌骨重建中髁突保留及再植技术对其治疗效果的评价  

Evaluation of therapeutic effect of condyle retention and replantation in mandibular reconstruction

作　　者：王琳[1,2,3] 贾玉林 WANG Lin;JIA Yu-lin(Department of Stomatology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430022,China;School of Stomatology,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China;Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration,Hubei Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院口腔医学中心,湖北武汉430022 [2]华中科技大学同济医学院口腔医学院,湖北武汉430030 [3]口腔颌面发育与再生湖北省重点实验室,湖北武汉430022

出　　处：《临床口腔医学杂志》2021年第9期553-556,共4页Journal of Clinical Stomatology

摘　　要：目的:评估下颌骨肿瘤切除术后针对髁突的不同的处置方式对其治疗效果的影响。方法:选取2018~2020年本院口腔诊疗中心收治41例血管化骨瓣下颌骨重建手术患者,分为保留髁突组、骨瓣替代组、冷冻再植组。患者术后1、3、6、12个月定期复查,进行受区及供区的临床检查和进食、语音功能及外形的评价。结果:Fricton颞下颌关节紊乱指数评价3种不同髁突处理方法及重建髁突位置、形态患者的DI、CMI值比较,差异有统计学意义(P<0.01)。保留髁突组DI和CMI值均明显低于骨瓣替代组,MM值差异无统计学意义。结论:下颌骨良性病变接近髁突时,若保留髁突,可行髁突冷冻再植,对颞下颌关节功能及下颌骨的形态及运动均有一定的积极意义。Objective:To assess the management of the condyle during the restoration of mandibular defects following tumor resection.Methods:A total of 41 patients who underwent simultaneous tumor resection and reconstruction with vascularized bone flaps for mandibular defects, from September 2018 to October 2020,were included.These patients were divided into three groups, condyle preserved, condyle sacrificed and condyle frozen.Patients were followed up at 1,3,6,and 12 months for the evaluation of appearance, occlusion, and speech.Results:The TMJ disability index(DI)and craniomandibular index(CMI)differed significantly according to the method of management, as well as of patients with condylar reconstruction(P<0.01).However, no statistically significant difference in mandible movement was observed between the groups.The DI and CMI values were significantly lower in condyle preserved group compared to condyle sacrificed group and condyle frozen group.Conclusion:The condyle should be preserved when benign mandibular lesions are situated near the condyle, as preservation has a positive effect on TMJ function and mandible movement.

关 键 词：下颌骨重建 髁突 血管化骨瓣 功能评价 

分 类 号：R782.2[医药卫生—口腔医学]