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颞肌筋膜瓣与皮片作为植入材料治疗颞下颌关节强直的临床疗效比较

Comparison of clinical efficacy of temporalis myofascial flap and dermal graft as interpositional material in treatment of temporomandibular joint ankylosis.

作者信息

Yazdani Javad, Ali Ghavimi Mohammad, Pourshahidi Sara, Ebrahimi Hooman

机构信息

Department of Oromaxillofacial Surgery, Tabriz University of Medical Science, Tabriz, Iran.

出版信息

J Craniofac Surg. 2010 Jul;21(4):1218-20. doi: 10.1097/SCS.0b013e3181e1b4f6.

Abstract

UNLABELLED

Temporomandibular joint (TMJ) ankylosis is a very distressing structural condition. Interpositional arthroplasty has become the acceptable standard for the primary surgical management of TMJ ankylosis. Up to now, diverse interpositional materials have been proposed in this regard, with especial advantages and limitations. The temporalis muscle and facial flap, as well as the dermal graft, are among the most popular ones. This study aimed to compare the short-term clinical consequences between these 2 interpositional materials in patients with operated TMJ ankylosis.

MATERIALS AND METHODS

Twenty patients with TMJ ankylosis were randomized in 2 age- and sex-matched 10-patient groups and received either a temporalis muscle and facial flap or a dermal graft as the interpositional material. The maximal incisal opening (MIO) and the amount of lateral excursion (LE) were measured before and 3 months after surgery, and the mandibular deviation (MD) at the mouth opening 3 months after operation was compared between the 2 groups.

RESULTS

Twenty patients were enrolled in the study. The presurgical MIO and LE were not significantly different between the 2 groups. Three months after the operation, evaluation of the patients did not reveal a significant difference considering the amount of the MIO, LE, or MD. The mentioned parameters were significantly improved 3 months after the operation in both groups.

CONCLUSIONS

The interpositional arthroplasty in TMJ ankylosis patients using either a temporalis muscle and facial flap or a dermal graft would yield a comparable and almost satisfactory clinical outcome.

摘要

未标注

颞下颌关节(TMJ)强直是一种非常令人苦恼的结构状况。间置关节成形术已成为TMJ强直一期手术治疗的可接受标准。到目前为止,在这方面已经提出了多种间置物材料,各有其特殊的优点和局限性。颞肌和面部皮瓣以及真皮移植是最常用的材料。本研究旨在比较这两种间置物材料在接受TMJ强直手术患者中的短期临床效果。

材料与方法

20例TMJ强直患者被随机分为年龄和性别匹配的两组,每组10例,分别接受颞肌和面部皮瓣或真皮移植作为间置物材料。在手术前及手术后3个月测量最大切牙开口度(MIO)和侧向运动度(LE),并比较两组术后3个月开口时的下颌偏斜度(MD)。

结果

20例患者纳入本研究。两组术前MIO和LE无显著差异。术后3个月,对患者的评估显示,在MIO、LE或MD的数值方面,两组之间没有显著差异。两组术后3个月上述参数均有显著改善。

结论

TMJ强直患者采用颞肌和面部皮瓣或真皮移植进行间置关节成形术,临床效果相当,且几乎令人满意。

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