Hossameldin R H, McCain J P, Dabus G
Lecturer of Oral & Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
Private Practice of Oral and Maxillofacial Surgery, 8940 North Kendall Drive, Suite 604E, Miami, FL 33176, USA; Chief of Oral and Maxillofacial Surgery, Baptist Health Systems; Chief of OMS Subdivision in General Surgery Dep., Herbert Wertheim College of Medicine FIU, Miami, FL.
Br J Oral Maxillofac Surg. 2017 Jul;55(6):584-588. doi: 10.1016/j.bjoms.2017.03.001. Epub 2017 Mar 31.
The aim of the present study was to assess the efficacy of using prophylactic embolisation of the internal maxillary artery to minimise the risk of bleeding during gap arthroplasty. We studied a prospective series of 14 patients with ankylosis of the temporomandibular joint (TMJ) between January 2011 and February 2016, who were under the care of one surgeon. They were all treated by embolisation of the internal maxillary artery 24hours before gap arthroplasty. The main outcome variable was estimated blood loss, and others included the need to extend the gap arthroplasty, and the risk of reankylosis. We studied nine women and five men, mean (SD) age 51 (18) years, seven with unilateral and seven with bilateral ankylosis. Their mean (SD) estimated blood loss was 136 (77) ml, which we considered to be minimal. Patients were followed-up at six-monthly intervals, during which time there was no reankylosis or limitation of mouth opening. No patient lost more than 250ml blood in total. Prophylactic embolisation of the internal maxillary artery seems to be beneficial and safe in the management of selected cases of ankylosis of the TMJ.
本研究的目的是评估采用上颌动脉预防性栓塞术以降低关节间隙成形术期间出血风险的疗效。我们对2011年1月至2016年2月期间由同一位外科医生诊治的14例颞下颌关节（TMJ）强直患者进行了一项前瞻性研究。他们均在关节间隙成形术前24小时接受了上颌动脉栓塞术。主要观察变量为估计失血量，其他变量包括是否需要扩大关节间隙成形术以及再强直的风险。我们研究了9名女性和5名男性，平均（标准差）年龄51（18）岁，其中7例为单侧强直，7例为双侧强直。他们的平均（标准差）估计失血量为136（77）ml，我们认为这是极少的。患者每6个月随访一次，在此期间未出现再强直或张口受限情况。没有患者总失血量超过250ml。上颌动脉预防性栓塞术在TMJ强直的特定病例管理中似乎是有益且安全的。
