[关节镜在颞下颌关节滑膜软骨瘤病诊断与治疗中的临床分析]
[Clinical analysis of arthroscopy used in the diagnosis and treatment of synovial chondromatosis of the temporomandibular joint].
作者信息
Qiao Yong-Ming, Wang Ying, Li Rui
机构信息
Dept. of Oral and Maxilloficial Surgery, the Stomatology Center of the First Affiliated Hospital of Zhengzhou University, Henan Provincial Key Laboratory of Oral Health Management and Cancer Prevention Medicine, Zhengzhou 450052, China.
出版信息
Hua Xi Kou Qiang Yi Xue Za Zhi. 2021 Apr 1;39(2):209-214. doi: 10.7518/hxkq.2021.02.013.
OBJECTIVES
To evaluate the value of arthroscopy in the diagnosis and treatment of synovial chondromatosis of the temporomandibular joint (TMJSC).
METHODS
The cases of 16 patients preliminarily diagnosed with TMJSC by magnetic resonance imaging (MRI) from July 2011 to December 2018 were analyzed retrospectively. If the diagnosis was confirmed by arthroscopy, the opening operation was performed. The preoperative MRI, arthroscopy and opening operation, postoperative pathology and postoperative MRI of confirmed cases were analyzed, and clinical follow-up was performed to evaluate the curative effect of open surgery. The degree of mouth opening and visual analogue scale (VAS) scores for pain pre-operation and during follow-up of the confirmed cases were analyzed by -test.
RESULTS
Fourteen cases of TMJSC were diagnosed by arthroscopy, consistent with the postoperative pathological diagnosis. Postoperative MRI examination showed that articular cavity lesions basically disappeared. Ten patients with synovial chondromatosis were followed-up (follow-up rate, 71.4%) from 6 months to 7 years and 8 months (average follow-up time, 17.6 months); no recurrence was found, and clinical symptoms improved by varying degrees. Before operation and at follow-up, test results of opening degree difference were =7.757, <0.05; -test results of VAS were =-3.274, <0.05.
CONCLUSIONS
Arthroscopy is essential in the diagnosis and treatment of TMJ synovial chondromatosis.
目的
评估关节镜检查在颞下颌关节滑膜软骨瘤病（TMJSC）诊断及治疗中的价值。
方法
回顾性分析2011年7月至2018年12月间16例经磁共振成像（MRI）初步诊断为TMJSC的患者病例。若关节镜检查确诊，则行开放手术。分析确诊病例的术前MRI、关节镜检查及开放手术、术后病理及术后MRI情况，并进行临床随访以评估开放手术的疗效。采用t检验分析确诊病例术前及随访期间的张口度及视觉模拟评分法（VAS）疼痛评分。
结果
关节镜检查确诊14例TMJSC，与术后病理诊断相符。术后MRI检查显示关节腔病变基本消失。对10例滑膜软骨瘤病患者进行了6个月至7年8个月（平均随访时间17.6个月）的随访（随访率71.4%）；未发现复发，临床症状有不同程度改善。术前与随访时，张口度差值t检验结果为t=7.757，P<0.05；VAS的t检验结果为t=-3.274，P<0.05。
结论
关节镜检查对TMJ滑膜软骨瘤病的诊断及治疗至关重要。
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