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多特雷手术:治疗关节结节气化患者复发性下颌关节脱位的一种替代方法。

Dautrey's procedure: an alternative for the treatment of recurrent mandibular dislocation in patients with pneumatization of the articular eminence.

作者信息

da Costa Ribeiro R, dos santos B J, Provenzano N, de Freitas P H L

机构信息

Graduate School of Dentistry, University of Campinas, Piracicaba, SP, Brazil.

São Leopoldo Mandic Dental School, Campinas, SP, Brazil.

出版信息

Int J Oral Maxillofac Surg. 2014 Apr;43(4):465-9. doi: 10.1016/j.ijom.2013.10.007. Epub 2013 Nov 12.

Abstract

Temporomandibular joint (TMJ) dislocation is an involuntary forward movement of the mandible beyond the articular eminence with the condyle remaining stuck in the anterior-most position, leaving the patient unable to close their mouth. Conservative treatment for this condition includes the injection of sclerosing agents or the intramuscular administration of botulinum toxin type A, while surgical therapy requires either removal or augmentation of the articular eminence. Once the surgical treatment plan has been determined, pneumatization of the articular eminence may turn a relatively simple procedure into a great surgical challenge. We present herein the cases of two patients suffering from recurrent mandibular dislocation who happened to have pneumatization of the articular eminences. Both patients were treated with a down-fracture of the zygomatic arch, known as Dautrey's procedure, modified by the application of a miniplate connecting the displaced arch and the lateral portion of the articular eminence. Neither patient had suffered a new episode of dislocation at their most recent postsurgical visit.

摘要

颞下颌关节(TMJ)脱位是指下颌骨不由自主地向前移动,超过关节结节,髁突仍卡在最前方位置,导致患者无法闭口。这种情况的保守治疗包括注射硬化剂或肌肉注射A型肉毒杆菌毒素,而手术治疗则需要切除或增高关节结节。一旦确定了手术治疗方案,关节结节的气化可能会使一个相对简单的手术变成一个巨大的手术挑战。我们在此介绍两例复发性下颌脱位患者的病例,他们恰好有关节结节气化。两名患者均接受了颧弓下骨折治疗,即所谓的道特雷手术,并通过应用微型钢板连接移位的颧弓和关节结节外侧部分进行了改良。两名患者在最近的术后随访中均未出现新的脱位发作。

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