Lin Li-Qin, Bai Shan-Shan, Wei Min
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
World J Clin Cases. 2019 Mar 6;7(5):650-655. doi: 10.12998/wjcc.v7.i5.650.
Congenital maxillomandibular syngnathia is an extremely rare disorder characterized by craniofacial malformations and inability to open the mouth adequately, which leads to problems with feeding, swallowing, and breathing as well as temporomandibular joint ankylosis. The main goal of the surgery is to release the ankylosis, establish functioning mandible, and prevent re-fusion. However, surgical procedures for this disease are rarely reported.
Here, we report a 7-mo-old girl with bilateral maxillomandibular syngnathia. The patient presented with difficulty in feeding, breathing, sounding, and swallowing and had developmental dysplasia. For treatment, we performed bone isolation by computer-assisted navigation and used silicone to fix the wound surface to prevent refusion of bone. To our knowledge, this is the only syngnathia case in the literature treated using computer-assisted navigation. With the guidance of precise navigation, we were able to minimize operation time by at least one hour, the patient's blood vessels, nerves, and tooth germs were well protected, and excessive bleeding was avoided. After six weeks, the patient showed improvement in mouth opening and no major issues of feeding.
Application of computer-assisted navigation can significantly improve accuracy, effectiveness, and surgical safety in correcting congenital maxillomandibular syngnathia.
先天性上颌下颌骨性融合是一种极为罕见的疾病，其特征为颅面畸形以及无法充分张口，这会导致进食、吞咽、呼吸问题以及颞下颌关节强直。手术的主要目标是松解强直、建立功能正常的下颌骨并防止再次融合。然而，针对这种疾病的手术操作鲜有报道。
在此，我们报告一名患有双侧上颌下颌骨性融合的7个月大女孩。该患者存在进食、呼吸、发声及吞咽困难，并有发育异常。为进行治疗，我们通过计算机辅助导航实施骨分离，并使用硅胶固定创面以防止骨再次融合。据我们所知，这是文献中唯一一例采用计算机辅助导航治疗的骨性融合病例。在精确导航的引导下，我们得以将手术时间至少缩短一小时，患者的血管、神经和牙胚得到了良好保护，且避免了过度出血。六周后，患者张口情况有所改善，进食方面无重大问题。
计算机辅助导航的应用可显著提高矫正先天性上颌下颌骨性融合的准确性、有效性及手术安全性。
