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经口入路关节镜辅助下保守性髁突切除术治疗髁突骨软骨瘤

Endoscope-assisted conservative condylectomy in the treatment of condylar osteochondroma through an intraoral approach.

作者信息

Yu H B, Sun H, Li B, Zhao Z L, Zhang L, Shen S G, Wang X D

机构信息

Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.

出版信息

Int J Oral Maxillofac Surg. 2013 Dec;42(12):1582-6. doi: 10.1016/j.ijom.2013.05.002. Epub 2013 Jun 20.

Abstract

Mandibular condylar osteochondroma (OC) can result in morphological and functional disturbances, including facial asymmetry and temporomandibular joint (TMJ) dysfunction. The aim of this study was to explore the feasibility of endoscope-assisted tumour resection and conservative condylectomy via an intraoral approach. Seven patients with condylar OC were enrolled in this study. Endoscope-assisted tumour resection and conservative condylectomy were achieved intraorally, and no conventional extraoral incision was needed. Direct vision of the magnified and illuminated operative field was realized with the assistance of an endoscope. No facial nerve injury or salivary fistula occurred in any patient. Stable occlusion was realized through postoperative orthodontic treatment. The patients showed no signs of tumour recurrence or TMJ ankylosis during follow-up (range 18-43 months). Endoscope-assisted condylar OC resection and conservative condylectomy via intraoral approach offers great advantages with no significant complications compared with conventional extraoral incisions. The endoscope provides us with a valuable treatment option for this potentially complicated procedure.

摘要

下颌髁突骨软骨瘤(OC)可导致形态和功能障碍,包括面部不对称和颞下颌关节(TMJ)功能障碍。本研究的目的是探讨通过口内入路在内镜辅助下进行肿瘤切除和保守性髁突切除术的可行性。本研究纳入了7例髁突OC患者。通过口内实现了内镜辅助肿瘤切除和保守性髁突切除术,无需传统的口外切口。在内镜辅助下实现了对放大和照明手术视野的直视。所有患者均未发生面神经损伤或涎瘘。通过术后正畸治疗实现了稳定的咬合。在随访期间(18 - 43个月),患者未出现肿瘤复发或TMJ强直的迹象。与传统口外切口相比,通过口内入路在内镜辅助下进行髁突OC切除和保守性髁突切除术具有很大优势,且无明显并发症。内镜为这一潜在复杂手术提供了一种有价值的治疗选择。

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