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颞下颌关节强直的治疗:11年临床经验

Management of temporomandibular joint ankylosis: 11 years' clinical experience.

作者信息

Zhi Keqian, Ren Wenhao, Zhou Hong, Gao Ling, Zhao Lu, Hou Chengqun, Zhang Yincheng

机构信息

Department of Oral and Maxillofacial Surgery/Oncologic Head and Neck Surgery, Stomatologic Hospital, Xi'an Jiaotong University, Shaanxi, China.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Nov;108(5):687-92. doi: 10.1016/j.tripleo.2009.06.041. Epub 2009 Sep 26.

Abstract

OBJECTIVE

Many surgical techniques to manage temporomandibular joint (TMJ) ankylosis have been described in the literature. The purpose of this paper is to report one institution's experience using various management techniques and to evaluate the results of these surgical interventions.

STUDY DESIGN

The records from our hospital of 42 patients treated for TMJ ankylosis between 1996 and 2007 were reviewed. Pre- and postoperative assessment included age, gender, etiology, ankylosis type/classification, existing facial asymmetry, maximal pre- and postoperative mouth opening, arthroplasty method (gap or interpositional arthroplasty), complications, and recurrence of ankylosis.

RESULTS

The mean maximal incisal opening in the preoperative period was 7.51 +/- 6.48 mm and in the post operative period was 27.74 +/- 7.86 mm. All patients experienced significant reduction of pain during function and resumed eating a normal diet. There was no facial nerve paralysis. There was recurrence in 3 cases.

CONCLUSION

Joint reconstruction with interpositional arthroplasty for the treatment of ankylosis proved to be effective regarding the prevention of recurrence and restoration of joint function and patient quality of life. Early postoperative exercises, appropriate physiotherapy, and close follow-up play an important role in the prevention of recurrence.

摘要

目的

文献中已描述了多种治疗颞下颌关节(TMJ)强直的外科技术。本文旨在报告一家机构使用各种治疗技术的经验,并评估这些外科干预的结果。

研究设计

回顾了我院1996年至2007年间42例治疗TMJ强直患者的记录。术前和术后评估包括年龄、性别、病因、强直类型/分类、现有的面部不对称、术前和术后最大开口度、关节成形术方法(间隙或植入性关节成形术)、并发症以及强直复发情况。

结果

术前平均最大切牙开口度为7.51±6.48毫米,术后为27.74±7.86毫米。所有患者在功能活动时疼痛均显著减轻,并恢复了正常饮食。未出现面神经麻痹。有3例复发。

结论

植入性关节成形术进行关节重建治疗强直在预防复发、恢复关节功能和患者生活质量方面被证明是有效的。术后早期锻炼、适当的物理治疗以及密切随访在预防复发中起着重要作用。

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