Wang Xiao-xia, Li Zi-li, Yi Biao, Liang Cheng, Li Yang, Wang Xing
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2012 May;47(5):305-9. doi: 10.3760/cma.j.issn.1002-0098.2012.05.013.
Condylectomy was performed to treat condylar osteoma or hyperplasia. Introduced two methods of condylectomy via intraoral approach and evaluated their clinical results.
Thirty-five patients, aging from 22 to 57.21 years, were treated by condylectomy via intraoral approach, of which 21 were condyle osteoma, 14 hemimandibular hyperplasia and condylar hyperplasia. Intraoral vertical ramus osteotomy (IVRO) were used in 32 patients and intraoral condylectomy via coronoid process resection was used in 3 patients.
The treatment results including oral function and facial symmetry after the operation were good in all patients. The temporomandibular joint (TMJ) dysfunction syndrome alleviated or disappeared. The follow-up period was 6 months to 3 years, and no relapse of condylar osteoma or hyperplasia was found. The patients who had IVRO and TMJ reconstruction had some degree of transplanted bone resorption, and one patients had relapse of facial deformity. But the patients who had intraoral condylectomy via coronoid process resection only had mild condyle remodeling and no obvious bone resorption was noted.
The two methods of intraoral condylectomy introduced in this stugy can successfully correct the facial deformity and TMJ dysfunction caused by condylar osteoma or hyperplasia. But the surgeons need to have excellent surgical skills and careful selection of the indications.
行髁突切除术治疗髁突骨瘤或增生。介绍两种经口内入路的髁突切除术方法并评估其临床效果。
35例患者,年龄22至57.21岁,采用经口内入路髁突切除术治疗,其中21例为髁突骨瘤,14例为半侧下颌骨增生及髁突增生。32例患者采用口内垂直升支截骨术(IVRO),3例患者采用经冠突切除的口内髁突切除术。
所有患者术后的治疗效果包括口腔功能和面部对称性均良好。颞下颌关节(TMJ)功能障碍综合征缓解或消失。随访6个月至3年,未发现髁突骨瘤或增生复发。接受IVRO和TMJ重建的患者有一定程度的移植骨吸收,1例患者面部畸形复发。但仅接受经冠突切除的口内髁突切除术的患者仅有轻度髁突重塑,未观察到明显的骨吸收。
本研究介绍的两种经口内髁突切除术方法可成功矫正由髁突骨瘤或增生引起的面部畸形和TMJ功能障碍。但外科医生需要具备精湛的手术技巧并仔细选择适应证。