Freihofer H P
Dept. of Oral and Maxillofacial Surgery, University Hospital, Nijmegen, The Netherlands.
J Craniomaxillofac Surg. 1991 Oct;19(7):289-98. doi: 10.1016/s1010-5182(05)80335-x.
Restricted opening of the mouth with an extra-articular cause (ROMEC) can have very different aetiologies. A series of 6 children, who have been operated on under 4 different diagnoses, are presented. Excluded are common problems such as recent trauma and posttraumatic scarring, craniomandibular dysfunction or elongated coronoid process, and also tumours. Problems of establishing the diagnosis, surgical treatment, postoperative physiotherapy and timing are discussed. It is shown that none of the cases is a perfect result, some outcomes are even very disappointing. It is therefore concluded that absolute trismus should be treated independently of age. The result expected will be mediocre. For final correction it is suggested that the operator should wait preferably until the second growth spurt has passed. The same goes for children presenting primarily with a mouth opening greater than 20 mm.
关节外原因导致的张口受限（ROMEC）可有非常不同的病因。本文介绍了一组6名儿童，他们接受了4种不同诊断的手术治疗。排除了近期创伤和创伤后瘢痕形成、颅下颌功能障碍或喙突过长等常见问题，以及肿瘤。讨论了诊断确立、手术治疗、术后物理治疗及时机选择等问题。结果显示，没有一例是完美的，有些结果甚至非常令人失望。因此得出结论，绝对牙关紧闭应独立于年龄进行治疗。预期结果将是中等的。对于最终矫正，建议手术医生最好等到第二个生长高峰期过去。对于主要表现为张口大于20毫米的儿童也是如此。
