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评估髁突骨折伴下颌窝和/或鼓板骨折。

Assessment of condylar fractures associated with mandibular fossa and/or tympanic plate fractures.

机构信息

Residency Program of Oral and Maxillofacial Surgery, Hospital João XXIII/FHEMIG, Belo Horizonte, Brazil; Oral and Maxillofacial Surgery Service, Complexo Hospitalar São Francisco, Belo Horizonte, Brazil; Oral and Maxillofacial Surgery Master Program, São Leopoldo Mandic University, Campinas, Brazil.

Residency Program of Oral and Maxillofacial Surgery, Hospital João XXIII/FHEMIG, Belo Horizonte, Brazil.

出版信息

Br J Oral Maxillofac Surg. 2022 Nov;60(9):1196-1201. doi: 10.1016/j.bjoms.2022.05.007. Epub 2022 May 28.

Abstract

Mandibular fractures are frequently diagnosed in trauma centres. Tympanic plate and mandibular fossa fractures can be associated with those fractures and can pass unnoticed if a careful evaluation and adequate imaging exam are not performed. This descriptive study was made to evaluate the incidence of condylar fractures associated with mandibular fossa and/or tympanic plate fractures in a large trauma hospital. Twenty-nine patients were diagnosed with such fractures between July/2019 and July/2020. A total of 81.5% of the patients were diagnosed with condylar fracture associated with tympanic plate fracture, 11.1% with a condylar fracture with mandibular fossa fracture, and 7.4% with condylar fracture associated with both tympanic plate and mandibular fossa fracture. Otorrhagia, trismus, malocclusion, and mouth opening deviation were the most observed clinical signs. Treatments performed were speech therapy, open reduction, and closed reduction. A total of 7.4% of the patients evolved with complications after the treatment. This study suggests that fractures of the tympanic plate and mandibular fossa may go unnoticed if an adequate imaging exam is not performed and rated by the surgeon. The early and corrected treatment prevents future sequelae, and a long-term follow up is essential.

摘要

下颌骨骨折在创伤中心经常被诊断出来。鼓室板和下颌窝骨折可与这些骨折相关,如果未进行仔细的评估和充分的影像学检查,可能会被忽视。本描述性研究旨在评估大型创伤医院中与下颌窝和/或鼓室板骨折相关的髁突骨折的发生率。在 2019 年 7 月至 2020 年 7 月期间,共诊断出 29 例此类骨折。总共 81.5%的患者被诊断为与鼓室板骨折相关的髁突骨折,11.1%的患者为与下颌窝骨折相关的髁突骨折,7.4%的患者为与鼓室板和下颌窝骨折均相关的髁突骨折。耳漏、牙关紧闭、咬合不正和张口偏斜是最常见的临床体征。进行的治疗包括言语治疗、切开复位和闭合复位。治疗后共有 7.4%的患者出现并发症。本研究表明,如果未进行充分的影像学检查并由外科医生进行评估,鼓室板和下颌窝骨折可能会被忽视。早期和正确的治疗可预防未来的后遗症,长期随访至关重要。

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