Schoen R, Fakler O, Metzger M C, Weyer N, Schmelzeisen R
Albert-Ludwigs-University, Freiburg, Germany.
Int J Oral Maxillofac Surg. 2008 Feb;37(2):111-6. doi: 10.1016/j.ijom.2007.06.017. Epub 2007 Sep 5.
Temporomandibular joint (TMJ) function was evaluated following endoscope-assisted transoral open reduction and miniplate fixation of displaced bilateral condylar mandibular fractures. The transoral treatment of bilateral condylar fractures was performed in 13 patients from May 2000 to December 2004. Eleven of the 13 patients had additional mandibular fractures. Out of 26 fractures of the condylar process, 11 were located at the condylar neck and 15 were subcondylar. One, 6 and 12 months after surgery TMJ function was evaluated. Anatomic reduction was achieved using an endoscope-assisted transoral approach even when the condylar fragment was displaced medially and in fractures with comminution. Good TMJ function was noted 6 and 12 months after surgery. Mouth opening was measured to be more than 40 mm without deviation. Postoperative range of motion with a satisfying lateral excursion was found. Early rehabilitation and pre-injury TMJ function was achieved following minimally invasive anatomic fracture reduction.
在内窥镜辅助经口切开复位及微型钢板固定双侧下颌骨髁突骨折后,对颞下颌关节(TMJ)功能进行了评估。2000年5月至2004年12月,对13例患者进行了双侧髁突骨折的经口治疗。13例患者中有11例合并有其他下颌骨骨折。在26处髁突骨折中,11处位于髁突颈部,15处为髁突下骨折。在术后1个月、6个月和12个月对TMJ功能进行评估。即使髁突骨折块向内移位以及存在粉碎性骨折,采用内窥镜辅助经口入路也能实现解剖复位。术后6个月和12个月时,TMJ功能良好。测量开口度超过40mm且无偏斜。术后发现有令人满意的侧向运动范围。通过微创解剖复位实现了早期康复及伤前TMJ功能。