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改良 Blair 入路治疗下颌骨髁突骨折。

Modified Blair Approach for the Treatment of Mandibular Condyle Fractures.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Baskent University, Ankara.

Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Adana.

出版信息

J Craniofac Surg. 2022 Oct 1;33(7):2231-2234. doi: 10.1097/SCS.0000000000008571. Epub 2022 Feb 25.

Abstract

PURPOSE

The management of fractures of the condyle of the mandible has been a topic of debate and still no consensus exists in the literature about the most appropriate approach. The objective of this study was to evaluate the efficacy and safety of the modified Blair approach for the open reduction and internal fixation of mandibular condyle fractures.

METHODS

A retrospective study was conducted on 18 patients with 20 mandibular condyle fractures from 2014 to 2020. All patients were treated surgically using the modified Blair approach. Postoperative occlusion status and mouth opening were assessed for treatment outcomes. Also, the rate of complications such as facial nerve paralysis, wound infection, hematoma, salivary fistula, Frey syndrome, and greater auricular nerve paraeesthesia evaluated.

RESULTS

Seventeen out of 18 patients (94.4%) achieved their original pretraumatic occlusion after the surgery. One patient (5.5%) had postoperative occlusal interference due to premature dental contact. The maximal postoperative interincisal distance was measured with a range between 33 and 41 mm (mean 37.6 mm). One patient (5.6%) had transient facial nerve palsy. Also, salivary fistula developed in 1 (5.6%) patient in the postoperative period.

CONCLUSION

The results of this study revealed that the modified Blair approach provides satisfactory clinical outcomes with low complication rates and may offer an alternative, safe, and effective method for open reduction and internal fixation of mandibular condyle fracture.

摘要

目的

下颌骨髁突骨折的治疗一直是一个有争议的话题,文献中仍然没有关于最适当方法的共识。本研究的目的是评估改良 Blair 入路在开放性下颌骨髁突骨折复位内固定中的疗效和安全性。

方法

对 2014 年至 2020 年间的 18 例 20 例下颌骨髁突骨折患者进行回顾性研究。所有患者均采用改良 Blair 入路手术治疗。术后评估咬合状态和张口度以评估治疗效果。还评估了面神经麻痹、伤口感染、血肿、涎瘘、Frey 综合征和耳大神经感觉异常等并发症的发生率。

结果

18 例患者中有 17 例(94.4%)在手术后恢复了原来的创伤前咬合。1 例(5.5%)患者由于过早的牙齿接触导致术后咬合干扰。最大术后切牙间距测量范围为 33-41mm(平均 37.6mm)。1 例(5.6%)患者出现暂时性面神经麻痹。此外,1 例(5.6%)患者在术后发生涎瘘。

结论

本研究结果表明,改良 Blair 入路提供了满意的临床结果,并发症发生率低,可能为开放性下颌骨髁突骨折复位内固定提供一种替代、安全、有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ce2/9518966/a390b709b41b/scs-33-2231-g001.jpg

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