Yabe Tetsuji, Tsuda Tomoyuki, Hirose Shunsuke, Ozawa Toshiyuki
Department of Plastic and Reconstructive Surgery, Ishikiri-Seiki Hospital, Osaka, Japan.
J Craniofac Surg. 2013 Jul;24(4):1365-7. doi: 10.1097/SCS.0b013e318285d9a3.
Preauricular transparotid approach without dissecting the facial nerve was used for surgical treatment of 15 condylar fractures in 14 patients. The parotid fascia was opened just above the fracture site, and by dissecting the parotid gland and masseter muscle, the fracture was directly exposed. The facial nerve itself was not dissected expressly. All fractures could be reduced accurately and fixed firmly with miniplates. A direct approach just above the fracture site provided good vision of the fracture, avoiding facial nerve palsy caused by strong retraction. Moreover, by not dissecting the facial nerve, the operation time was shortened. This approach was useful for surgical treatment of both condylar neck and subcondylar fractures.
采用不解剖面神经的耳前经腮腺入路对14例患者的15处髁突骨折进行手术治疗。在骨折部位上方切开腮腺筋膜，通过解剖腮腺和咬肌直接暴露骨折。未特意解剖面神经本身。所有骨折均能准确复位并用微型钢板牢固固定。骨折部位上方的直接入路能提供良好的骨折视野，避免因强力牵拉导致面神经麻痹。此外，不解剖面神经缩短了手术时间。该入路对髁突颈部和髁突下骨折的手术治疗均有用。
