Zheng Li Wu, Dong Shi Ying, Li Jing Wen, Wu Zhong Xing
Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR; and.
Department of Oral & Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Hubei, China.
J Craniofac Surg. 2022 Oct 1;33(7):2216-2219. doi: 10.1097/SCS.0000000000008515. Epub 2022 Feb 3.
The present study aimed to investigate the clinical efficacy of simultaneous management of condylar osteochondroma and its secondary dentofacial deformities using an intraoral surgical approach.
Six patients with condylar osteochondroma were treated with intraoral vertical ramus osteotomies and condylar resection. The free rising branch was used for reconstructing the temporomandibular joint. The simultaneous orthognathic surgery and plastic surgery were performed sequentially to correct the secondary dentofacial deformities. The indexes of aesthetic symmetry, occlusion relationship, temporomandibular joint function, condylar height, and volume change were assessed in the subsequential follow up.
The mean follow up period was 31 months. All patients had no tumor recurrence. The ipsilateral joint function, occlusal relationship, and facial symmetry were satisfied. The ipsilateral condylar reconstruction had no obvious bone resorption and the ramus height was maintained well. Postoperative assessment showed the preoperative design was accurately fulfilled.
The simultaneous condylar osteochondroma resection and temporomandibular joint reconstruction using intraoral approach avoids extraoral scars and correct facial asymmetry without compromising the long-term joint function and occlusal relationship.
本研究旨在探讨采用口内手术方法同时治疗髁突骨软骨瘤及其继发牙颌面畸形的临床疗效。
对6例髁突骨软骨瘤患者采用口内垂直升支截骨术及髁突切除术治疗。游离升支用于重建颞下颌关节。依次进行正颌手术和整形手术以纠正继发牙颌面畸形。在后续随访中评估美学对称性、咬合关系、颞下颌关节功能、髁突高度和体积变化等指标。
平均随访期为31个月。所有患者均无肿瘤复发。同侧关节功能、咬合关系及面部对称性均令人满意。同侧髁突重建无明显骨吸收，升支高度保持良好。术后评估显示术前设计得以准确实现。
采用口内入路同时进行髁突骨软骨瘤切除和颞下颌关节重建，可避免面部瘢痕，纠正面部不对称，且不影响关节功能和咬合关系的长期稳定性。
