标准型颞下颌关节假体置换术中保存翼外肌附着的效果评价  

Preliminary clinical evaluation of lateral pterygoid muscle preservation in total temporomandibular joint reconstruction with stock prosthesis

作　　者：岳史婧 赵炅 白果[1] 陈敏洁[1] 杨驰[1] YUE Shi-jing;ZHAO Jiong;BAI Guo;CHEN Min-jie;YANG Chi(Department of Oral Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology.Shanghai 200011,China)

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

出　　处：《中国口腔颌面外科杂志》2022年第6期548-553,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-037);上海市科委公共服务平台项目(21DZ2292000)。

摘　　要：目的:探讨标准型颞下颌关节假体置换术中保存翼外肌(lateral pterygoid muscle,LPM)附着的临床效果。方法:提出一种优化髁突截骨而在标准型关节假体置换手术中将翼外肌保留在翼肌窝上的新方法,并与常规术式相比较,验证该肌肉保存、重建新方法的可行性和有效性。采用SPSS 25.0软件包对数据进行统计学分析。结果:本回顾性研究纳入12例使用标准型人工关节完成关节置换手术的患者,其中,LPM(+)组有7侧关节使用新方法保存翼外肌,LPM(-)组有7侧关节采用常规髁突截骨不保存翼外肌。手术后,LPM(+)组下颌侧方运动功能恢复显著改善,平均侧方运动距离为3.14 mm;而LPM(-)组仅为0.29 mm(P<0.01)。中长期随访结果显示,LPM(+)组术后骨愈合良好,翼外肌位置稳定。结论:翼外肌功能重建有利于颞下颌关节置换术后患者的下颌运动功能恢复,这种新方法可有效保存翼外肌,维持翼外肌功能。PURPOSE:To investigate the clinical effect of retaining lateral pterygoid muscle(LPM)during standard tem-poromandibular joint(TMJ)prosthesis replacement.METHODS:A new method that LPM was kept attached to the pterygoid muscle fossa through proper condyle osteotomy was tried to preserve LPM during total joint reconstruction(TJR).Compared with the conventional operation,the feasibility and effectiveness of the new method for muscle preservation and reconstruction were verified.SPSS 25.0 software package was used for data analysis.RESULTS:Twelve patients with a total of 14 joints undergoing TJR with LPM preservation were included in this retrospective study.Lateral movement of all7 joints in LPM(+)group that preserved LPM were restored post-operation,with an average 3.14 mm of lateral moving dis-tance,much higher than that in LPM(-)group(0.29 mm,P<0.01).In addition,bone healed well and LPM located stably.CONCLUSIONS:LPM preservation is essential for function regain of mandible lateral movement post TJR operation and this new method can be utilized to preserve LPM.

关 键 词：翼外肌保存 假体置换 颞下颌关节 

分 类 号：R782.6[医药卫生—口腔医学]