Chen Min-Jie, Yang Chi, Huang Dong, He Dong-Mei, Wang Yi-Wen, Zhang Wen-Hao
Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.
Head Neck. 2017 Dec;39(12):2562-2566. doi: 10.1002/hed.24924. Epub 2017 Sep 30.
The purpose of this article is to introduce the modified technique of preservation of the inferior alveolar nerve (IAN) during mandibulectomy for a benign lesion.
Five cases of osteofibrous hyperplasia and 3 cases of centricity osteomyelitis were included. During surgery, the IAN was marked using a planned cutting guide. Using an oscillating saw, the depth of the osteotomy along the IAN was controlled until the bone cortex was cut through. After splitting, the bony section was removed, leaving the neurovascular bundle intact. The sensation of the lower lip was evaluated using current perceptive threshold testing during follow-up.
After follow-up for 6-27 months, no recurrence or secondary deformity was found. One patient had severe sensory disturbance.
With the use of a cutting guide and osteotomy tricks, mandibulectomy with preservation of the IAN can be accurately performed.
本文旨在介绍下颌骨良性病变切除术时保留下牙槽神经(IAN)的改良技术。
纳入5例骨纤维异常增殖症和3例中央性骨髓炎患者。手术过程中,使用预定切割导板标记IAN。使用摆锯,控制沿IAN截骨的深度,直至穿透骨皮质。劈开后,去除骨块,保留神经血管束完整。随访期间使用电流感觉阈值测试评估下唇感觉。
随访6 - 27个月,未发现复发或继发畸形。1例患者出现严重感觉障碍。
通过使用切割导板和截骨技巧,可准确实施保留IAN的下颌骨切除术。