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Matthews 装置关节成形术在治疗颞下颌关节强直方面,其长期张口度优于间置关节成形术。

Matthews device arthroplasty presents superior long-term mouth opening than interpositional arthroplasty in the management of temporomandibular joint ankylosis.

机构信息

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Sao Paulo, Brazil.

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Sao Paulo, Brazil.

出版信息

J Plast Reconstr Aesthet Surg. 2016 Aug;69(8):1052-8. doi: 10.1016/j.bjps.2016.04.001. Epub 2016 May 4.

Abstract

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.

摘要

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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