Department of Dentistry, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan.
Department of Dentistry, Classic Dental Clinic, Tainan 70260, Taiwan.
J Formos Med Assoc. 2019 Jul;118(7):1161-1165. doi: 10.1016/j.jfma.2018.12.025. Epub 2019 Jan 7.
Dislocation of the mandibular condyle is one of several consequences of facial trauma that can be anticipated. The condylar neck is inherently weak and likely to fracture at the time of impact before dislocating into the middle cranial fossa. A review of the literature revealed that most cases of dislocation of the mandibular condyle into the middle cranial fossa are treated by open reduction and internal fixation via an extraoral approach or are treated conservatively with closed reduction. An intraoral approach is rare. Here we present a patient with traumatic dislocation of the mandibular condyle into the middle cranial fossa who was treated successfully by condylectomy and coronoidectomy through an intraoral approach and intermaxillary fixation followed by mouth-opening exercises and rehabilitation. Stable occlusion and movement of the mandible was achieved and the long-term results have been good. The intraoral approach may be an option in patients with traumatic dislocation of the mandibular condyle into the middle cranial fossa.
下颌骨髁突脱位是颌面外伤的几种后果之一，可以预见。髁颈固有脆弱，在撞击时容易骨折，然后脱位至中颅窝。文献复习显示，大多数下颌骨髁突脱位至中颅窝的病例通过经口外入路的切开复位内固定治疗，或通过闭合复位保守治疗。经口内入路很少见。在此，我们介绍了一位创伤性下颌骨髁突脱位至中颅窝的患者，我们通过经口内入路行髁突切除术和喙突切除术，并采用颌间固定，随后进行张口练习和康复治疗，成功地进行了治疗。患者获得了稳定的咬合和下颌运动，长期效果良好。经口内入路可能是外伤性下颌骨髁突脱位至中颅窝患者的一种选择。
