Shi Pengwei, Hu Jing, Li Yunfeng, Ye Bin, Luo En
From the West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, People's Republic of China.
J Craniofac Surg. 2014 Mar;25(2):367-71. doi: 10.1097/SCS.0000000000000634.
Osteochondroma of the mandibular condyle could cause secondary facial asymmetry; besides, it could affect the function of the temporomandibular joint (TMJ) and occlusion. Conventional treatments include total condylectomy or local resection of the lesion and condylar reconstruction. But it cannot effectively ameliorate the facial asymmetry. Thus, this article presents the application of combination surgeries including condylectomy, sliding vertical ramus osteotomy, and mandibular contouring in the treatments of this kind of disease. From 2007 to 2012, 12 patients with osteochondroma of the mandibular condyle were included. All of them accepted condylectomy, sliding vertical ramus osteotomy, and mandibular contouring at 1 stage. Mandibular contouring included mandibular inferior border ostectomy, mandibular outer cortex ostectomy, and horizontal osteotomy genioplasty according to the characters of jaw deformity. In addition, maximal mouth opening, pain in the TMJ, and numbness of the lower lip were recorded preoperatively and postoperatively to evaluate the therapeutic effects. All of patients obtained satisfactory results; TMJ dysfunction, facial asymmetry, and abnormal occlusion were improved greatly. No patients developed recurrence of the tumor during the follow-up period. In conclusion, after condylectomy, sliding vertical ramus osteotomy and mandibular contouring were operated at 1 stage, which effectively ameliorated the condylar osteochondroma patient's facial asymmetry and abnormal occlusion and achieved good therapeutic effects.
下颌髁突骨软骨瘤可导致继发性面部不对称;此外,它还会影响颞下颌关节(TMJ)的功能和咬合。传统治疗方法包括全髁突切除术或病变局部切除术及髁突重建术。但它无法有效改善面部不对称。因此,本文介绍了包括髁突切除术、垂直升支滑动截骨术和下颌轮廓整形术在内的联合手术在这类疾病治疗中的应用。2007年至2012年,纳入了12例下颌髁突骨软骨瘤患者。他们均在一期接受了髁突切除术、垂直升支滑动截骨术和下颌轮廓整形术。下颌轮廓整形术根据颌骨畸形特点包括下颌下缘截骨术、下颌外皮质截骨术和水平截骨颏成形术。此外,术前和术后记录最大开口度、TMJ疼痛和下唇麻木情况以评估治疗效果。所有患者均取得满意结果;TMJ功能障碍、面部不对称和异常咬合均得到极大改善。随访期间无患者出现肿瘤复发。总之,在一期进行髁突切除术、垂直升支滑动截骨术和下颌轮廓整形术后,有效改善了髁突骨软骨瘤患者的面部不对称和异常咬合,取得了良好的治疗效果。