Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan.
Department of Oral Maxillofacial Surgery, School of Dentistry, Pusan National University, Busan, South Korea.
J Craniofac Surg. 2022 Sep 1;33(6):e546-e550. doi: 10.1097/SCS.0000000000008362. Epub 2022 Feb 9.
The aim of this study was to review retrospectively the functional recoveries of subcondylar fracture patients that underwent open reduction surgery using an extraoral approach or an intraoral approach using a trans-buccal trocar and involving ramus buccal decortication.
Of 47 patients with mandibular condyle fracture who visited Pusan National University Dental Hospital Department of Oral and Maxillofacial Surgery between May 2015 and November 2020, 38 patients underwent open reduction and were classified according to the surgical method used. Preauricular, submandibular, and retro-mandibular approaches were all classified as extraoral approaches condyle fractures were classified as described by Spiessl and Schroll (1972). Distances between bone fragments on panorama radiographs before and after surgery were measured.
Thirty-eight patients were included in this study, 9 patients received subcondylar fracture surgery. Open reduction surgery using an extraoral approach had a greater mean operation time than the intraoral approach using a trocar. Of the 17 patients treated with an intraoral approach, the average distance between bone fragments right after surgery was 1.27 ± 1.41mm, which was significantly greater than that of the extraoral approach (0.72 ± 0.35 mm).
Favorable results can be obtained by mandibular condylar fracture surgery through an intraoral approach using a trans-buccal trocar with ramus buccal decortication. This technique minimizes scarring, secures accessibility using a trocar, and sufficiently secures the field of view through buccal cortical bone reduction.
本研究旨在回顾性分析经口内入路（使用颊侧穿通套管）联合颊侧升支骨皮质切开术与经口外入路行切开复位术治疗髁突骨折患者的功能恢复情况。
在 2015 年 5 月至 2020 年 11 月期间，共有 47 例下颌骨髁突骨折患者就诊于釜山国立大学牙科学院口腔颌面外科，其中 38 例行切开复位术，并根据手术方法进行分类。经耳前、下颌下和下颌后入路均被分类为口外入路，髁突骨折分类采用 Spiessl 和 Schroll（1972 年）的方法。测量术前和术后全景片上骨块之间的距离。
本研究共纳入 38 例患者，其中 9 例为下颌髁突骨折患者。与经口内套管入路相比，经口外入路行切开复位术的平均手术时间更长。在 17 例行经口内套管入路的患者中，术后即刻骨块之间的平均距离为 1.27±1.41mm，明显大于经口外入路（0.72±0.35mm）。
经口内入路（使用颊侧穿通套管）联合颊侧升支骨皮质切开术治疗髁突骨折可获得良好的效果。该技术最大限度地减少了瘢痕形成，套管的使用确保了可及性，并通过颊侧皮质骨切开术充分保证了术野暴露。
