He Y, Huang T, Zhang Y, An J, He L
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China.
Int J Oral Maxillofac Surg. 2017 Feb;46(2):189-197. doi: 10.1016/j.ijom.2016.10.006. Epub 2016 Nov 10.
This retrospective study evaluated the effect of surgical computer-assisted navigation in temporomandibular joint (TMJ) ankylosis gap arthroplasty. Eighteen patients (25 sides) with bony ankylosis who underwent surgical treatment under computer-assisted navigation (navigation group) from May 2011 to April 2013 were assessed, along with 19 such patients (25 sides) treated without computer-assisted navigation (non-navigation group) from March 2009 to April 2011. The navigation group patients underwent surgery with the preservation of ≥3mm bone thickness in the skull base and anterior wall of the external auditory canal. Postoperatively, computed tomography (CT) was used to measure the residual bone thickness in the skull base and anterior wall of the external auditory canal. Maximum mouth opening (MMO) changes were evaluated at >1 year of follow-up. Postoperative CT measurements showed that the lowest skull base thickness in the navigation group was significantly lower than that in the non-navigation group (3.86±1.95mm vs. 6.01±3.07mm, P=0.009). The lowest thicknesses of the anterior wall of the external auditory canal were similar in the two groups. Postoperative follow-up showed similar average MMO in the two groups. Therefore, with the navigation system, TMJ ankylosis gap arthroplasty can achieve more extensive removal of the ankylosed bone, at least towards the skull base, under the premise of ensuring a safety distance of 3mm.
本回顾性研究评估了手术计算机辅助导航在颞下颌关节(TMJ)强直间隙关节成形术中的效果。对2011年5月至2013年4月期间在计算机辅助导航下接受手术治疗的18例(25侧)骨性强直患者(导航组)进行了评估,并与2009年3月至2011年4月期间未接受计算机辅助导航治疗的19例(25侧)此类患者(非导航组)进行了比较。导航组患者手术时保留颅底和外耳道前壁骨厚度≥3mm。术后,使用计算机断层扫描(CT)测量颅底和外耳道前壁的残余骨厚度。在随访超过1年时评估最大开口度(MMO)变化。术后CT测量显示,导航组的最低颅底厚度显著低于非导航组(3.86±1.95mm对6.01±3.07mm,P = 0.009)。两组外耳道前壁的最低厚度相似。术后随访显示两组的平均MMO相似。因此,使用导航系统,TMJ强直间隙关节成形术在确保3mm安全距离的前提下,至少朝着颅底方向能够更广泛地去除强直骨。
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