Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Sao Paulo, Brazil.
Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Sao Paulo, Brazil.
J Plast Reconstr Aesthet Surg. 2016 Aug;69(8):1052-8. doi: 10.1016/j.bjps.2016.04.001. Epub 2016 May 4.
BACKGROUND: The aim of this study is to describe the surgical outcomes of a single-institution experience in the surgical management of temporomandibular joint ankylosis, comparing interpositional arthroplasty with autogenous tissue and Matthews device arthroplasty. METHODS: A retrospective analysis of temporomandibular joint ankylosis patients (n = 15), who underwent interpositional arthroplasty or Matthews device arthroplasty, was conducted. The surgical outcomes (preoperative, recent [4-6 weeks], intermediate [1 year], and late [3 years] postoperative maximal incisal opening, hospital stay, and complication, relapse, and reoperation rates) were compared. RESULTS: Significant (all p < 0.05) differences were recorded in temporomandibular joint ankylosis patients treated with interpositional arthroplasty with autogenous tissue (53.3%) versus Matthews device arthroplasty (46.7%) according to intermediate (25 ± 7 vs. 34 ± 5 mm) and late (19 ± 8 vs. 33 ± 5 mm) postoperative maximal incisal opening, intermediate (31% vs. 7%) and late (47% vs. 12%) postoperative relapse, and reoperation rate (38% vs. 0%). There was similarity (all p > 0.05) in preoperative (4.8 ± 2.9 vs. 4.9 ± 2.9 mm) and recent (35 ± 4 vs. 37 ± 4 mm) postoperative maximal incisal opening, hospital stay (3.5 ± 0.8 vs. 3.6 ± 0.8 days), and surgery-related complications (13% vs. 14%). CONCLUSION: Both surgical procedures evaluated were successful in initial management of temporomandibular joint ankylosis, but the Matthews device arthroplasty avoided postoperative relapse.
背景：本研究旨在描述单中心在颞下颌关节强直的外科治疗中的经验，比较了使用同种异体组织和 Matthews 装置的间置关节成形术的手术结果。
方法：对 15 例接受间置关节成形术或 Matthews 装置关节成形术的颞下颌关节强直患者进行回顾性分析。比较了手术结果（术前、近期[4-6 周]、中期[1 年]和晚期[3 年]术后最大张口度、住院时间以及并发症、复发和再手术率）。
结果：根据中期（25±7 对 34±5mm）和晚期（19±8 对 33±5mm）术后最大张口度、中期（31%对 7%）和晚期（47%对 12%）术后复发率以及再手术率（38%对 0%），自体组织间置关节成形术（53.3%）与 Matthews 装置关节成形术（46.7%）的颞下颌关节强直患者之间存在显著差异（均 p<0.05）。术前（4.8±2.9 对 4.9±2.9mm）和近期（35±4 对 37±4mm）术后最大张口度、住院时间（3.5±0.8 对 3.6±0.8 天）和手术相关并发症（13%对 14%）均相似（均 p>0.05）。
结论：两种手术方法均成功地用于颞下颌关节强直的初始治疗，但 Matthews 装置关节成形术可避免术后复发。
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