Nam Seung Min, Kim Yong Bae, Lee Sun Jae, Park Eun Soo, Lee Jang Hyun
Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, 170 Jomaru-ro, Bucheon, 14584, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Hanyang University, College of Medicine, 153, Gyeongchun-ro, Guri, 11923, Republic of Korea.
BMC Surg. 2019 Mar 5;19(1):28. doi: 10.1186/s12893-019-0487-7.
The purpose of this study was to compare the outcomes and effectiveness between intraoral approach and retromandibular approach for treatment of subcondylar fracture of mandible.
Between March 2011 and October 2013, 24 patients with subcondylar fractures of the mandible were treated by a single surgeon with an intraoral approach using an angulated screwdriver (n = 14) or by another surgeon using a retromandibular approach (n = 10). The interincisal distance was measured 1 week (T0), 6 weeks (T1), 3 months (T2), and 6 months (T3) postoperatively. We also compare the average operation time and the cost of operation between the two groups.
At 6 months postoperatively, all 24 patients achieved satisfactory ranges of temporomandibular joint movement, with an interincisal distance > 40 mm without deviation and with stable centric occlusion. The intraoral group had the median interincisal distance of 14 mm at T0, 38 mm at T1, 42.5 mm at T2, and 43 mm at T3, while the retromandibular group had that of 15, 29, 35, and 42.5 mm respectively. There was no statistically significant difference between the intraoral and the retromandibular group at T0 and T4. However, significant differences were noted T1 and T2 (p < 0.01). The differences of average operation time between the intraoral (81 min) and retromandibular group (45 min) were statistically significant (p < 0.01). The cost of an operation was 369.96 ± 8.14 (United States dollar [USD]) in intraoral group and was 345.48 ± 0.0 (USD) in retromandibular group. The differences between the two groups were statistically significant (p < 0.01).
In open reduction of a subcondylar fracture of the mandible, a intraoral approach using an angulated screwdriver is superior to the retromandibular approach in terms of interincisal distance, although the operation time is longer.
本研究的目的是比较口内入路和下颌后入路治疗下颌骨髁突骨折的疗效和有效性。
2011年3月至2013年10月期间，24例下颌骨髁突骨折患者由一位外科医生采用口内入路使用成角螺丝刀治疗（n = 14），或由另一位外科医生采用下颌后入路治疗（n = 10）。术后1周（T0）、6周（T1）、3个月（T2）和6个月（T3）测量切牙间距离。我们还比较了两组的平均手术时间和手术费用。
术后6个月，所有24例患者颞下颌关节活动范围均达到满意，切牙间距离>40mm，无偏斜，正中咬合稳定。口内组T0时切牙间距离中位数为14mm，T1时为38mm，T2时为42.5mm，T3时为43mm，而下颌后组分别为15、29、35和42.5mm。口内组和下颌后组在T0和T4时无统计学显著差异。然而，在T1和T2时观察到显著差异（p < 0.01）。口内组（81分钟）和下颌后组（45分钟）平均手术时间的差异具有统计学意义（p < 0.01）。口内组手术费用为369.96±8.14（美元[USD]），下颌后组为345.48±0.0（USD）。两组之间的差异具有统计学意义（p < 0.01）。
在下颌骨髁突骨折切开复位中，使用成角螺丝刀的口内入路在切牙间距离方面优于下颌后入路，尽管手术时间更长。
