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面部骨折成人的口腔运动和肌电图特征:不同骨折严重程度之间的比较。

Oral motor and electromyographic characterization of adults with facial fractures: a comparison between different fracture severities.

作者信息

da Silva Amanda Pagliotto, Sassi Fernanda Chiarion, Bastos Endrigo, Alonso Nivaldo, de Andrade Claudia Regina Furquim

机构信息

Divisao de Miologia Orofacial, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2017 May;72(5):276-283. doi: 10.6061/clinics/2017(05)04.

Abstract

OBJECTIVES

: To characterize the oral motor system of adults with facial injuries and to compare the oral motor performance/function between two different groups.

METHODS

: An observational, descriptive, cross-sectional study was conducted in 38 patients presenting with facial trauma who were assigned to the Division of Orofacial Myology of a Brazilian School Hospital. Patients were divided into two groups: Group 1 (G1) consisted of 19 patients who were submitted to open reduction of at least one facial fracture, and Group 2 (G2) consisted of 19 individuals who were submitted to closed fracture reduction with maxillomandibular fixation. For comparison purposes, a group of 19 healthy volunteers was recruited. All participants underwent a clinical assessment that included an oral motor evaluation, assessment of the mandibular range of motions, and electromyographic assessment of the masticatory muscles.

RESULTS

: Clinical assessment of the oral motor organs indicated that G1 and G2 presented deficits related to the posture, position, and mobility of the oral motor organs. Patients also presented limited mandibular ranges of movement. Deficits were greater for individuals in G1, especially for maximal incisor opening. Additionally, patients in G1 and G2 presented a similar electromyographic profile of the masticatory muscles (i.e., patients with facial fractures presented lower overall muscle activity and significant asymmetrical activity of the masseter muscle during maximum voluntary teeth clenching).

CONCLUSION

: Patients in G1 and G2 presented similar functional deficits after fracture treatment. The severity of facial fractures did not influence muscle function/performance 4 months after the correction of fractures.

摘要

目的

描述面部受伤成人的口腔运动系统,并比较两个不同组之间的口腔运动表现/功能。

方法

对38例面部创伤患者进行了一项观察性、描述性横断面研究,这些患者被分配到巴西一所学校医院的口面肌功能科。患者分为两组:第1组(G1)由19例至少有一处面部骨折接受切开复位的患者组成,第2组(G2)由19例接受颌间固定闭合性骨折复位的个体组成。为了进行比较,招募了一组19名健康志愿者。所有参与者都接受了临床评估,包括口腔运动评估、下颌运动范围评估以及咀嚼肌的肌电图评估。

结果

口腔运动器官的临床评估表明,G1组和G2组在口腔运动器官姿势、位置和活动度方面存在缺陷。患者下颌运动范围也有限。G1组个体的缺陷更大,尤其是最大切牙开口度。此外,G1组和G2组患者咀嚼肌的肌电图表现相似(即面部骨折患者在最大自主紧咬牙时总体肌肉活动较低,咬肌有明显不对称活动)。

结论

G1组和G2组患者在骨折治疗后存在相似的功能缺陷。面部骨折的严重程度在骨折矫正4个月后并未影响肌肉功能/表现。

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