Wang Yanliang, Pan Lini, Xu Hui
From the *Stomatological Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; †School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; and ‡The Orthopaedic Department, the 2nd Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
J Craniofac Surg. 2014 Nov;25(6):e521-3. doi: 10.1097/SCS.0000000000000505.
Penetrating injuries with reinforced screwed steel bar in the skull base represent a unique challenge for oral maxillofacial surgeons. Management of these injuries is complicated by associated injuries and the proximity to vital neurovascular structures. A 35-year-old man was admitted to our hospital because of injury due to a downward fall upon a reinforced steel rod. Radiologic studies of the skull base revealed that the steel bar traversed the temporomandibular space between the left cervical spine and the mastoid process to the space between the inner side of the left mandibular ramus and the maxilla. We performed osteotomy of the left mastoid process tip and the left mandibular ramus to take out the steel bar from the maxilla and repaired the left mandible with internal fixation. Appropriate preoperative planning, including three-dimensional computed tomographic images, is integral in the surgical approach for the safe removal of such objects.
颅底被加固螺纹钢筋穿透性损伤对口腔颌面外科医生来说是一项独特的挑战。这些损伤的处理因合并伤以及与重要神经血管结构毗邻而变得复杂。一名35岁男性因从高处坠落至加固钢筋上受伤而入住我院。颅底影像学检查显示，钢筋穿过左颈椎和乳突之间的颞下颌间隙，到达左下颌支内侧与上颌之间的间隙。我们对左乳突尖和左下颌支进行截骨，以便从颌骨中取出钢筋，并通过内固定修复左下颌骨。适当的术前规划，包括三维计算机断层扫描图像，对于安全取出此类异物的手术方法至关重要。
