颌后入路在髁突中低位骨折手术中的应用<br />-《中国美容医学》

文章信息/Info

Title:: Application of Retromandibular Approach in Subcondylar Fracture Surgery

Keywords:: Key words: retromandibular approach; subcondylar fractures; facial contour; occlusal relationship; nerve protection; clinical effects

摘要:: [摘要]目的：探讨经颌后切口入路法在髁突中低位骨折手术治疗中的临床应用效果，为进一步临床推广提供实践依据。方
法：回顾性分析2015年10月-2017年10月在南京市口腔医院口腔颌面外科经影像学确诊髁突中低位骨折的21例患者资料，采
用颌后切口入路法切开复位内固定，观察术后张口度、咬合关系、涎瘘、面神经症状以及颞下颌关节复位等情况。结果：21
例患者均取得良好的解剖复位，X线复查骨折断端无成角或裂开。临床效果显示术后咬合关系、张口度、开口型均可恢复正
常，无永久面瘫、涎瘘病例出现。结论：经颌后切口入路治疗髁突中低位骨折，面形及咬合关系均恢复良好，充分保护面神
经分支，且能达到髁突解剖复位和坚固内固定的治疗效果。

Abstract:: Abstract: Objective To investigate the application of retromandibular approach in the treatment of subcondylar fractures,
and to provide practical evidence for promotion in clinical practice. Methods The baseline clinical data of 21 patients with
subcondylar fractures diagnosed by CT imaging in Department of Oral and Maxillofacial Surgery,Nanjing Stomatological
Hospital from October 2015 to October 2017 were retrospectively analyzed. They were subjected to incision and internal
fixation through the retromandibular approach. The postoperative degree of mouth opening, occlusal relationship, salivary
fistula, facial nerve symptoms and temporomandibular joint reduction were observed. Results All the 21 patients underwent
satisfactory anatomical reduction.X-ray re-examination showed no angulation or rupture of the fracture end. The postoperative
occlusal relationship, mouth opening degree and opening type were all restored to normal, without permanent facial paralysis
or salivary fistula. Conclusion The retromandibular approach for treating subcondylar fractures was beneficial to the recovery
of facial contour and occlusal relationship, which can protect the facial nerve branches as well as allow condylar anatomical
reduction and firm internal fixation.