Oztan Hasan Yucel, Ulusal Betul Gozel, Aytemiz Cemal
Department of Plastic Surgery, Izmir Ataturk Research and Training Hospital, Izmir, Turkey.
J Craniofac Surg. 2004 Mar;15(2):274-82; discussion 282. doi: 10.1097/00001665-200403000-00024.
The purpose of this pilot study was to analyze the role of different types of trauma in the formation of temporomandibular joint ankylosis. The specific aim was to explore the physical and histological effects of trauma on temporomandibular joint and mandibular growth. Fifty-five growing white male guinea pigs were used for the study. Initially, cadaveric studies were performed (n = 1) to assess the topographic anatomy of the temporomandibular joint region. Animals were then assigned to pilot (n = 4), experimental (n = 40), and control (n = 10) groups. The pilot group was used to assess the technical feasibility of creating various trauma types and endurance of the animals to the surgery. Four types of trauma were carried out in the experimental group: A) intra-articular hematoma (n = 10), B) mechanical damage to the articular surface (n = 10), C) fracture of the condyle neck (n = 10), and D) excision of the condyle head (n = 10). Each trauma group was further divided into two subgroups. Procedures were performed unilaterally or bilaterally in the subgroups. In the control group, no procedure was performed. Subjects were examined after a 2-month follow-up period. The development and anatomical structure of the mandible were evaluated, and histopathological assessment of the temporomandibular joint was carried out in each group. The results revealed that hyaline cartilage of the condylar head had an important role in the development of the mandible and traumas targeting this site may cause ankylosis, growth retardation, and resultant facial malformations. Hence, mechanical damage to the articular surface (B1, B2) and resection of the condylar head (D1, D2) almost always resulted in ankylosis. Intra-articular hematoma alone (A1, A2) was established not be a causative factor for ankylosis formation, however.
本初步研究的目的是分析不同类型创伤在颞下颌关节强直形成中的作用。具体目标是探讨创伤对颞下颌关节和下颌骨生长的物理及组织学影响。55只生长中的白色雄性豚鼠用于该研究。最初,进行了尸体研究(n = 1)以评估颞下颌关节区域的局部解剖结构。然后将动物分为预试验组(n = 4)、实验组(n = 40)和对照组(n = 10)。预试验组用于评估造成各种创伤类型的技术可行性以及动物对手术的耐受性。实验组进行了四种类型的创伤:A)关节内血肿(n = 10),B)关节表面机械损伤(n = 10),C)髁突颈部骨折(n = 10),D)髁突头部切除(n = 10)。每个创伤组进一步分为两个亚组。亚组中手术单侧或双侧进行。对照组不进行任何手术。在2个月的随访期后对受试者进行检查。评估下颌骨的发育和解剖结构,并对每组颞下颌关节进行组织病理学评估。结果显示,髁突头部的透明软骨在颌骨发育中起重要作用,针对该部位的创伤可能导致关节强直、生长发育迟缓及由此产生的面部畸形。因此,关节表面的机械损伤(B1、B2)和髁突头部切除(D1、D2)几乎总是导致关节强直。然而,单独的关节内血肿(A1、A2)并非关节强直形成的致病因素。