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下颌髁突及髁突下骨折固定术后面神经损伤及涎囊肿形成的发生率。

Incidence of Facial Nerve Injury and Sialocele Formation Following Mandibular Condylar and Sub-condylar Fracture Fixation.

作者信息

Kulkarni Vishal, Chowdhury S K Roy, Ghosh Sirsendu, Rajkumar K

机构信息

Armed Forces Medical College, Pune, Maharastra India.

出版信息

J Maxillofac Oral Surg. 2024 Apr;23(2):380-386. doi: 10.1007/s12663-021-01674-2. Epub 2021 Nov 28.

Abstract

PURPOSE

To study the incidence of sialocele formation in the parotid gland and to study the incidence of facial nerve affliction following treatment of mandibular condylar and sub-condylar fractures.

MATERIALS AND METHODS

The present study is a retrospective study conducted on a total of 82 patients with 107 sub-condylar and condylar fractures treated in this centre from August 2008 to August 2020. The surgical approaches used to treat the fractures were considered, and the occurrence of sialocele, salivary fistula and facial nerve paralysis was noted. The facial nerve function was analysed using House-Brackmann system of classification.

RESULTS

The incidence of sialocele formation was seen in 15.87% of cases, and the incidence was seen more commonly during a preauricular approach (52.94%) followed by retromandibular (41.17%) followed by anterior parotid transmassetric approach (11.76%). The incidence of facial nerve affliction was seen in 17.57% of cases with majority of them showing temporal branch involvement in 21.05% of cases.

CONCLUSION

During the treatment of condylar and sub-condylar fractures, the facial nerve is at considerable risk of damage; however, understanding the anatomy of the nerve is of importance to avoid such complications. Sialocele formation is also an undesirable complication of such surgeries, a prompt diagnosis and early treatment is mandatory to overcome further unwanted sequel.

摘要

目的

研究腮腺涎囊肿形成的发生率,并研究下颌髁突及髁突下骨折治疗后面神经受累的发生率。

材料与方法

本研究是一项回顾性研究,共纳入了2008年8月至2020年8月在本中心接受治疗的82例患者的107处髁突下和髁突骨折。考虑了治疗骨折所采用的手术入路,并记录了涎囊肿、涎瘘和面神经麻痹的发生情况。使用House-Brackmann分类系统分析面神经功能。

结果

涎囊肿形成的发生率为15.87%,该发生率在耳前入路时更为常见(52.94%),其次是下颌后入路(41.17%),然后是腮腺前经咬肌入路(11.76%)。面神经受累的发生率为17.57%,其中大多数病例(21.05%)表现为颞支受累。

结论

在髁突和髁突下骨折的治疗过程中,面神经有相当大的受损风险;然而,了解神经的解剖结构对于避免此类并发症很重要。涎囊肿形成也是此类手术的不良并发症,必须进行及时诊断和早期治疗以避免进一步的不良后果。

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本文引用的文献

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Delayed treatment of parotid sialocele: a functional approach and review.
J Oral Maxillofac Surg. 2015 Feb;73(2):284-90. doi: 10.1016/j.joms.2014.08.039. Epub 2014 Sep 16.
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Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.经咬肌前腮腺前路治疗髁突骨折:129例经验
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