保留关节支高度的再轮廓间隙置换术治疗颞下颌关节强直1例(新技术)

IF 0.2 Q4 EMERGENCY MEDICINE
F. Akhlaghi, M. Majd
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引用次数: 0

摘要

背景:颞下颌关节强直(TMJ)是下颌髁突椎间盘与颞关节面之间的囊内愈合,限制了下颌功能。TMJ强直的治疗需要微创方法。目的:本研究旨在提出一种新的手术方法,以尽可能地恢复关节强直后的关节支高度。病例介绍:2例颞下颌关节强直患者参与了本研究。患者术前最大开口分别为3mm和9mm。采用一种新的方法分离髁突与关节盂窝之间的骨融合。然后对下颌支的髁突头进行整形,最后采用颞肌筋膜瓣作为间位移植物。患者随访6个月。两例手术均在伊朗德黑兰Shahid Beheshti医科大学Taleghani医院口腔颌面外科进行。结果:两例患者术后平均最大开口35 ~ 40mm。结论:对于颞下颌关节强直患者,可通过解除强直部位后常规间隙关节置换术去除髁突与颧弓之间过多的骨,使支比另一侧短。然而,使用这种方法,髁头也被重塑,因此比其他技术保留了更多的分支长度;如果有必要,将来的正颌手术或牵张成骨术(DO)也会更容易。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Re-Contouring Interpositional Gap Arthroplasty with Ramus Height Preservation for Treatment of Temporomandibular Joint Ankylosis: Case Report (New Technique)
Background: Ankylosis of the temporomandibular joint (TMJ) is an intracapsular union between the mandibular condylar disc and the temporal articular surface that restricts mandibular functions. The management of TMJ ankylosis requires minimally invasive methods. Objectives: This study aims to present a new surgical method for restoring ramus height as much as possible after condylectomy of the TMJ due to ankylosis. Case Prsentation: Two patients with TMJ ankylosis participated in this investigation. Patients’ preoperative maximal mouth openings were 3 mm and 9 mm. A new method was used to separate the bony fusion between the condyle and the glenoid fossa. Then, the condylar head on the mandibular ramus was recontoured, and finally the temporalis musculofascial flap was employed as an interpositional graft. Patients were followed for six months. Both surgeries were performed at the Department of Oral and Maxillofacial Surgery of Taleghani Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. Results: Both patients had an average maximal mouth opening of 35-40 mm postoperatively. Conclusion: In patients who have TMJ ankylosis   the excessive bone between the condyle and the zygomatic arch can be removed by releasing the ankylotic site followed by routine gap arthroplasty so that the ramus becomes shorter than the other side. With this method, however, the condylar head is also recontoured, thus preserving more ramus length than with other techniques; future orthognatic surgery or distraction osteogenesis (DO), if necessary, will also be easier.
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来源期刊
Trauma monthly
Trauma monthly EMERGENCY MEDICINE-
CiteScore
0.60
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