Brown Emma, Wilson Mark H, Revington Peter
Department of Oral and Maxillofacial Surgery, North Bristol NHS Trust, Bristol, UK.
Department of Oral and Maxillofacial Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
BMJ Case Rep. 2016 Oct 8;2016:bcr2015213917. doi: 10.1136/bcr-2015-213917.
We present a case of a man aged 20 years who was referred with the inability to open his mouth as a consequence of severe ankylosis of his temporomandibular joint. He had previously undergone an attempt to release the ankylosis at the referring institution; however, this was complicated by an extradural haematoma as a result of iatrogenic injury. We describe a one-stage procedure which provided safe excision of the ankylotic mass along with immediate total joint replacement with a custom implant. We advocate the use of preoperative vascular imaging along with the use of custom-made cutting guides to minimise vascular injury.
我们报告一例20岁男性病例，该患者因颞下颌关节严重强直而无法张口。他之前在转诊机构曾尝试松解强直，但因医源性损伤导致硬膜外血肿，使情况变得复杂。我们描述了一种一期手术方法，该方法能安全切除强直肿块，并立即用定制植入物进行全关节置换。我们主张术前进行血管成像，并使用定制的切割导板，以尽量减少血管损伤。
