Adnot Jérôme, Feuss Aliosha, Duparc Fabrice, Trost Olivier
Department of Oral and Maxillofacial Surgery, Charles-Nicolle Hospital, University Hospital of Rouen, 1 rue de Germont, 76031, Rouen, France.
Laboratory of Anatomy, Rouen Faculty of Medicine, 22 boulevard Gambetta, 76000, Rouen, France.
Surg Radiol Anat. 2017 Oct;39(10):1079-1084. doi: 10.1007/s00276-017-1853-8. Epub 2017 Apr 20.
The purpose of this anatomic study was to compare the retraction force necessary to expose the mandibular neck in the Risdon and the high cervical anteroparotid transmasseteric (HAT) approaches.
An anatomic study was performed on 18 formalin-embalmed cadavers. We performed a Risdon approach on the left side, and an HAT approach on the right side in all the cases. The subjects were placed in a normative frame and the force necessary to maintain a satisfactory exposure of the condyle was measured with a system of cables, pulleys, and mechanical dynamometer. The statistical comparison between the two sides was carried out using the Wilcoxon signed-rank test for paired series.
In all the cases, the region of interest was exposed as in the operating room. In the Risdon approach, the mean force was 32 Newtons (4-47). In the HAT approach, the mean force was 19 Newtons (4-33). The difference was statistically significant (p < 0.001). The age, gender, and duration of conservation had no influence on the retraction force.
In the HAT approach, the retraction of the soft tissues was significantly lower than in the Risdon approach. This study gave an additional explanation to the remarkable safety of the HAT approach. Our results were in favor of the generalization of this technique.
本解剖学研究的目的是比较在里斯登（Risdon）入路和高位颈前腮腺咬肌下（HAT）入路中暴露下颌颈所需的牵拉力量。
对18具用福尔马林防腐的尸体进行解剖学研究。在所有病例中，左侧采用里斯登入路，右侧采用HAT入路。将受试者置于标准框架中，使用缆绳、滑轮和机械测力计系统测量维持髁突满意暴露所需的力量。使用配对系列的威尔科克森符号秩检验对两侧进行统计学比较。
在所有病例中，感兴趣区域均如在手术室中那样暴露。在里斯登入路中，平均力量为32牛顿（4 - 47）。在HAT入路中，平均力量为19牛顿（4 - 33）。差异具有统计学意义（p < 0.001）。年龄、性别和保存时间对牵拉力量无影响。
在HAT入路中，软组织的牵拉明显低于里斯登入路。本研究为HAT入路显著的安全性提供了额外的解释。我们的结果支持推广该技术。
