Dept. of Oral and Ma-xillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, China.
Dept.of Stomatology, Yanjiang District People's Hospital of Ziyang, Ziyang 641300, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2023 Jun 1;41(3):290-296. doi: 10.7518/hxkq.2023.2022496.
This study aimed to analyze the application value of a modified tragus edge incision and transmasseteric anteroparotid approach to condyle reconstruction.
Condyle reconstruction was performed in 16 patients (9 females and 7 males) with modified tragus edge incision and transmasseteric anteroparotid approach. After regular follow-up, the function of condyle reconstruction was evaluated by clinical indicators, such as parotid salivary fistula, facial nerve function, mouth opening, occlusal relationship, and facial scar. The morphology of rib graft rib cartilage was evaluated by imaging indicators, such as panoramic radiography, CT, and three-dimensional CT image reconstruction.
At 6-36 months postoperative follow-up, all patients had good recovery of facial appearance, concealed incisional scar, no parotid salivary fistula, good mouth opening, and occlusion. One case had temporary facial paralysis and recovered after treatment. Radiographic evaluation further showed that costochondral graft survived in normal anatomic locations.
The modified tragus edge incision and transmasseteric anteroparotid approach can effectively reduce parotid salivary fistula and facial nerve injury in condylar reconstruction. The surgical field was clearly exposed, and the incision scar was concealed without increasing the incidence of other complications. Thus, this approach is worthy of clinical promotion.
本研究旨在分析改良耳屏缘切口经咬肌前缘腮腺前入路在下颌骨髁突重建中的应用价值。
16 例患者(9 例女性,7 例男性)采用改良耳屏缘切口经咬肌前缘腮腺前入路行下颌骨髁突重建。定期随访后,通过临床指标如腮腺涎瘘、面神经功能、张口度、咬合关系和面部瘢痕等来评估髁突重建的功能。通过影像学指标如全景片、CT 和三维 CT 图像重建来评估肋软骨移植肋软骨的形态。
术后 6-36 个月随访时,所有患者面部外观恢复良好,切口瘢痕隐蔽,无腮腺涎瘘,张口度和咬合良好。1 例出现暂时性面瘫,经治疗后恢复。影像学评估进一步显示,肋软骨移植物在正常解剖位置存活。
改良耳屏缘切口经咬肌前缘腮腺前入路可有效减少下颌骨髁突重建中的腮腺涎瘘和面神经损伤。手术视野清晰暴露,切口瘢痕隐蔽,且不增加其他并发症的发生率。因此,该入路值得临床推广。