摘要
目的:采用颌后切口经腮腺前缘入路与穿腮腺入路2种术式分别治疗髁突骨折,比较2种手术方式的术后疗效。方法:选择2013年1月～2017年6月我院收治的52例髁突骨折病人,随机分为2组,改良切口组采用经颌后切口腮腺前缘入路,对照组采用传统的经颌后切口穿腮腺入路。术后随访6～36月,通过手术时间、骨折复位情况、开口度、咬合关系、面神经损伤及涎瘘发生率方面进行手术疗效的分析评价。结果:改良切口组:手术平均时间为79.60 min;所有患者术后骨折复位、开口度及咬合关系恢复良好;出现1例暂时性面神经损伤;无涎瘘发生。对照组:手术平均时间为86.40 min;所有病人术后骨折复位、开口度及咬合关系恢复良好;出现5例暂时性面神经损伤,1例永久性面神经损伤;4例发生涎瘘。结论:经颌后切口腮腺前缘入路的手术方法行髁突骨折切开复位内固定术可有效降低术中面神经损伤和术后涎瘘的发生率,且缩短了手术时间,没有增加其他并发症的发生,值得临床推广。
Objective:To compare postoperative curative effects of condylar fractures by anteroparotid approach and transparotid approach of retromandibular incisions.Method:This study consisted of 52 cases with condylar fractures treated at the Affiliated Stomatology Hospital of Southwest Medical University between January 2013 and June 2017.Fifty-two cases were randomly divided into modified incision group and control group.The patients of the modified incision group with condylar fractures accepted surgical treatment by the anteroparotid of retromandibular incisions,while the patients of the control group with condylar fractures accepted surgical treatment by the transparotid approach of retromandibular incisions.During the follow-up period of 6-36 months,the curative effects were evaluated based on operation time,fracture restoration,mouth opening,occlusion relationship,facial nerve injury,and salivary fistula.Results:Modified incision group:the average operation time was 79.60 min;all patients recovered well in fracture restoration,mouth opening and occlusion relationship;1 case of temporary facial nerve injury occurred;and no case of salivary fistulas occurred.Control group:the average operation time was 86.40 min;all patients recovered well in fracture restoration,mouth opening and occlusion relationship;facial nerve injuries happened in 6 cases,1 of which was permanent and 5 of which were temporary facial nerve injuries;4 cases had postoperative salivary fistulas.Conclusion:Compared with the traditional transparotid approach of retromandibular incisions,the anteroparotid approach of retromandibular incisions effectively reduced the intraoperative facial nerve injury and postoperative salivary fistulas in the treatment of condylar fractures by opening reduction and internal fixation.Moreover,it shortened the operation time,and did not increase the incidence of other complications.Therefore,it was worthy of clinical expansion.
作者
杨双林
赵文杰
孙黎波
吴双江
付光新
肖金刚
YANG Shuang-lin;ZHAO Wen-jie;SUN Li-bo;WU Shuang-jiang;FU Guang-xin;XIAO Jin-gang(Department of Oral and Maxillofacial Surgery,The Affiliated Stomatology Hospital of Southwest Medical University,Luzhou 646000,China;Department of Oral and Maxillofacial Surgery,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Orofacial Reconstruction and Regeneration Laboratory,The Affiliated Stomatology Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《口腔医学研究》
CAS
北大核心
2019年第4期355-359,共5页
Journal of Oral Science Research
基金
国家自然科学基金(编号:81870746
81371125)
中华口腔医学会西部行临床科研基金项目(编号:CSA-W2017-08)
关键词
髁突骨折
手术入路
颌后切口
面神经损伤
涎瘘
Condylar fracture
Surgical approach
Retromandibular incision
Facial nerve injury
Salivary fistula
