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经改良的耳屏缘和咬肌前缘经腮腺入路治疗髁突囊内和颈骨折。

Modified Tragus Edge and Transmasseteric Anteroparotid Approach for Intracapsular and Condylar Neck Fractures.

机构信息

Department of Oral and Maxillofacial Surgery.

Department of Oral Implantology.

出版信息

J Craniofac Surg. 2020 Sep;31(6):1822-1826. doi: 10.1097/SCS.0000000000006470.

Abstract

The aim of this study was to evaluate the effects of protecting the facial nerve and reducing the scar visibility using a modified tragus edge and transmasseteric anteroparotid approach compared to classic preauricular approach for intracapsular and condylar neck fractures. This retrospective study included 64 patients (78 sides) who underwent surgical treatment for intracapsular or condylar neck fractures from January 2014 to June 2018. Patients were divided into the experimental group (treated via a modified tragus edge and transmasseteric anteroparotid approach), and the control group (treated via the classical preauricular approach). Therapeutic outcome assessment parameters included facial nerve injury, salivary fistulae, wound infection, restricted mouth opening, postoperative occlusion disorders, and scar visibility. In the control group, there were 3 cases of facial nerve injuries and 2 cases of salivary fistulae. One case of temporary facial nerve injury occurred in the experimental group, with complete recovery within 1 month. The scars were less visible in the experimental group than in the control group. These results suggest that a modified tragus edge and transmasseteric anteroparotid approach reduced the incidences of facial nerve injuries, minimized the scar visibility, improved exposure of the operative site and fixation of titanium screws or plates, and did not increase the frequency of other complications.

摘要

本研究旨在评估与经典耳前入路相比,使用改良耳屏缘和咬肌前缘经腮腺前入路保护面神经和减少疤痕可见度在治疗关节囊内和髁突颈骨折中的效果。这项回顾性研究纳入了 2014 年 1 月至 2018 年 6 月期间因关节囊内或髁突颈骨折接受手术治疗的 64 名患者(78 侧)。患者被分为实验组(采用改良耳屏缘和咬肌前缘经腮腺前入路治疗)和对照组(采用经典耳前入路治疗)。治疗效果评估参数包括面神经损伤、涎瘘、伤口感染、张口受限、术后咬合紊乱和疤痕可见度。在对照组中,有 3 例面神经损伤和 2 例涎瘘。实验组有 1 例暂时性面神经损伤,1 个月内完全恢复。实验组的疤痕比对照组更不明显。这些结果表明,改良耳屏缘和咬肌前缘经腮腺前入路可降低面神经损伤的发生率,最大限度地减少疤痕的可见度,改善手术部位的显露和钛钉或板的固定,且不会增加其他并发症的发生频率。

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