髁突骨折采用经颌后切口腮腺前缘入路的疗效及术后颞下颌关节功能与咬合关系的影响  

The effect of transmaxillary incision anterior parotid approach on condylar fracture and the effect of temporomandibular joint function on occlusal relationship

作　　者：潘志崇[1] 黄莅 韦均闵 赵亮[1] PAN Zhi-chong;HUANG Li;WEI Jun-min;ZHAO Liang(Department of Stomatology,Hechi People's Hospital,Guangxi Hechi 547000,China)

机构地区：[1]河池市人民医院口腔科,广西河池547000

出　　处：《临床口腔医学杂志》2024年第9期551-554,共4页Journal of Clinical Stomatology

基　　金：河池市科技计划项目(编号:AB200717)。

摘　　要：目的:探索髁突骨折采用经颌后切口腮腺前缘入路的疗效及术后颞下颌关节功能及咬合关系的影响。方法:前瞻性选取的104例单侧髁突骨折患者均在2020年5月~2023年12月期间收治,根据随机数字表法分为2组。对照组52例采用传统经颌后切口穿腮腺入路,观察组52例采用经颌后切口腮腺前缘入路,比较两组患者术后恢复情况。结果:两组患者术后颞下颌关节功能及咬合关系均恢复良好,比较髁突骨折复位有效率、咬合关系、侧方运动幅度、下颌后退运动、下颌前伸运动值以及张口度恢复情况均无统计学差异(P>0.05)。观察组术中出血量[(29.57±4.24)mL]少于对照组,手术时间[(77.29±9.34)min]短于对照组(P<0.05),术后并发症(3.85%vs 19.23%)低于对照组(χ^(2)=6.029,P=0.014)。结论:颌后径路手术操作方法均能使髁突骨折患者颞下颌关节功能、咬合关系得到良好的恢复,且选择经颌后切口腮腺前缘入路手术时间短,出血量更少。Objective:To explore the effect of transmaxillary incision anterior parotid approach on condylar fracture and the effect of temporomandibular joint function and occlusal relationship.Methods:Prospectively selected 104 patients with unilateral condylar fractures were admitted between May 2020 and December 2023 and divided into 2 groups according to random number table method.The control group(52 cases)underwent traditional transmaxillary incision through parotid gland approach,and the observation group(52 cases)underwent transmaxillary incision through anterior parotid gland approach.The postoperative recovery of the two groups was compared.Results:The two groups recovered well in the function and occlusion of the temporomandibular joint after surgery,with no statistically significant difference in the effective reduction of condylar fracture,occlusal relationship,lateral motion amplitude,mandibular backward movement,mandibular forward extension motion value,and recovery of mouth opening(P>0.05).The intraoperative blood loss in the observation group[(29.57±4.24)mL]was less than the control group,and the operation time[(77.29±9.34)min]was shorter than the control group(P<0.05).Meanwhile,postoperative complications(3.85%vs 19.23%)were lower than those in the control group(χ^(2)=6.029,P=0.014).Conclusion:The posterior mandibular approach can restore temporomandibular joint function and occlusal relationship well in patients with condylar fracture,and the transmandibular anterior parotid approach with posterior incision can shorten the operation time and reduce blood loss.

关 键 词：髁突骨折 颌后径路手术 疗效 颞下颌关节 咬合功能 

分 类 号：R782.6[医药卫生—口腔医学]