Rouen University Hospital, Department of Oral and Maxillofacial Surgery, F 76000 Rouen, France.
Rouen University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, F 76000 Rouen, France; Laboratory of Anatomy, Faculty of Medicine-Pharmacy, Rouen-Normandie University, 22 Boulevard Gambetta, 76183, Rouen, France.
J Stomatol Oral Maxillofac Surg. 2022 Oct;123(5):e598-e603. doi: 10.1016/j.jormas.2022.05.006. Epub 2022 May 8.
The purpose of this study was to evaluate the reliability and reproducibility of a novel approach for base and neck fractures of the mandible. An anatomical study was conducted on 22 given to Science subjects. A rhytidectomy-like approach was performed, followed by a transmasseteric anteroparotid dissection. Measures were taken of the incision length and bone exposure at every step. The identification of a ramus of the facial nerve during dissection was noted. The subjects were classified according to their facial adiposity. A correlation coefficient was measured between incision length and bone exposure as well as morphotype and bone exposure. Statistical analysis was carried out using the Pearson method for linear correlation, and Chi2 test for further analysis. Adequate condylar exposure was always achieved in the area of interest (i.e. in the main localization of base and neck fractures). There was no correlation between the length of the cranial cutaneous backcut and the bone exposure horizontally (p = 0.3296) or vertically (p = 0.8382). There was no correlation between the total length of the incision and the bone exposure horizontally (p = 0.5171) or vertically (p = 0.8404). There was a significant correlation between the subjects' facial adiposity and the bone exposure horizontally and vertically (p<0.005). This approach allowed adequate bone exposure to the mandible base and neck, with a possible 90° angulation of instruments for optimal bone fixation. The incidence of facial nerve rami identification during dissection was similar to other approaches. The scarring was hidden. These results allowed us to propose this approach in a clinical study.
本研究旨在评估一种新的下颌骨基底和颈部骨折方法的可靠性和可重复性。在 22 名志愿受试者中进行了一项解剖学研究。采用类似除皱术的入路，然后进行经咬肌前腮腺解剖。在每一步都测量切口长度和骨暴露程度。记录在解剖过程中发现面神经分支的情况。根据受试者的面部肥胖程度进行分类。测量切口长度与骨暴露程度、形态与骨暴露程度之间的相关系数。使用 Pearson 线性相关分析法进行统计分析，并使用 Chi2 检验进行进一步分析。在感兴趣区域（即基底和颈部骨折的主要定位区域）始终能充分暴露髁突。颅后皮切口长度与骨暴露水平（p=0.3296）或垂直（p=0.8382）之间无相关性。切口总长度与骨暴露水平（p=0.5171）或垂直（p=0.8404）之间无相关性。受试者的面部肥胖程度与骨暴露水平和垂直呈显著相关性（p<0.005）。这种方法允许对下颌骨基底和颈部进行充分的骨暴露，并可进行 90°的器械角度以进行最佳的骨固定。在解剖过程中发现面神经分支的发生率与其他方法相似。瘢痕隐匿。这些结果使我们能够在临床研究中提出这种方法。
