Sharma Rohit
Graded Specialist, Dept of Oral & Maxillofacial Surgery, HQ IMTRAT, C/O 99 APO, Bhutan.
Med J Armed Forces India. 2012 Jul;68(3):231-5. doi: 10.1016/j.mjafi.2011.11.001. Epub 2012 May 9.
Norman's procedure is a well known surgical technique for the hypermobility of temporomandibular joint. In this procedure after performing glenotemporal osteotomy the augmentation of the zygomatic root of the temporal bone is done by placing a bone graft from the iliac crest to prevent forward movement of the condyle beyond the eminence. This paper describes the clinical outcome of two modifications added to Norman's procedure. In addition to the conventional procedure inferiorly based pedicled flap from the temporal fascia was sutured to the antero-lateral aspect of the capsule. Intraorally pterygoid disjunction was carried out only in those case in which hypermobility was associated with painful temporomandibular joint disorder.
Modified Norman's procedure was performed in 10 patients (4 females & 6 males), 7 of them were bilateral and 3 cases were unilateral under general anesthesia.
After one year follow up in none of the cases graft failed or rejected though recurrence along with TMJ pain was noticed in 2 cases.
This technique is versatile but long-term follow up on a larger number of patients is necessary to be able to draw definitive conclusions.
诺曼手术是一种治疗颞下颌关节活动度过大的著名外科技术。在该手术中，进行颞下颌关节截骨术后，通过植入取自髂嵴的骨块来增加颞骨颧突，以防止髁突向前移动超过关节结节。本文描述了对诺曼手术进行的两项改良的临床结果。除了传统手术外，将颞筋膜下蒂皮瓣缝合至关节囊的前外侧。仅在那些活动度过大伴有疼痛性颞下颌关节紊乱的病例中进行口内翼状肌分离。
10例患者（4例女性，6例男性）接受了改良诺曼手术，其中7例为双侧，3例为单侧，均在全身麻醉下进行。
随访一年，无一例骨块失败或排斥，但有2例出现复发并伴有颞下颌关节疼痛。
该技术具有通用性，但需要对更多患者进行长期随访才能得出明确结论。
