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颞下颌关节罕见的后盘移位——病例报告

Uncommon Posterior Disc Displacement of Temporomandibular Joint - A Case Report.

作者信息

AlKandari Ahmad Gh, Karkar Khalid Tarek

机构信息

Department of Oral and Maxillofacial Surgery, Farwaniya Specialized Dental Center/Al-Farwaniya Hospital, Farwaniya, Kuwait.

出版信息

Ann Maxillofac Surg. 2024 Jan-Jun;14(1):81-84. doi: 10.4103/ams.ams_167_23. Epub 2024 Mar 20.

DOI:10.4103/ams.ams_167_23
PMID:39184418
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11340843/
Abstract

RATIONALE

Posterior disc displacement (PDD) is an uncommon condition in which disc tissue is located between the posterior surface of the condyle and post-glenoid tubercle. The etiopathogenesis of this condition is idiopathic. There are different predisposing factors in the literature which are consistent with the presented case such as lack of anterior prominence of the disc, thinning of the posterior zone of the disc and perforation of the disc.

PATIENT CONCERNS

We report an uncommon temporomandibular joint (TMJ) arthropathy case of a 33-year-old female patient, who presented with long-standing TMJ pain associated with limited mouth opening.

DIAGNOSIS

The patient was diagnosed with non-reducible PDD of TMJ bilaterally.

TREATMENT

Open surgery of TMJ (Discopexy) was the choice of treatment to release and mobilise discs.

OUTCOMES

A noticeable increase in mouth opening without pain in TMJ area was achieved immediately after surgery and remained stable during periodic follow-ups.

TAKE-AWAY LESSONS: The importance of magnetic resonance imaging as a diagnostic tool for arthropathy, to determine the proper management is essential. Moreover, the root of the helix inter tragus notch incision presents an advantage of open surgery of TMJ which results in immediate outcome with limited complications.

摘要

理论依据

后盘移位(PDD)是一种罕见的情况,其中盘组织位于髁突后表面和关节盂后结节之间。这种情况的病因是特发性的。文献中有不同的易感因素与本病例相符,如盘前突不足、盘后区变薄和盘穿孔。

患者情况

我们报告了一例33岁女性患者的罕见颞下颌关节(TMJ)关节病病例,该患者长期存在TMJ疼痛并伴有张口受限。

诊断

该患者被诊断为双侧TMJ不可复性PDD。

治疗

TMJ开放手术(盘固定术)是释放和活动盘的治疗选择。

结果

术后立即实现了张口明显增加且TMJ区域无疼痛,并且在定期随访期间保持稳定。

经验教训

磁共振成像作为关节病诊断工具对于确定适当的治疗至关重要。此外,耳轮脚间切迹切口具有TMJ开放手术的优势,可立即取得效果且并发症有限。

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本文引用的文献

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A letter to the editor on "Root of helix inter tragus notch incision (RHITNI) for temporomandibular open surgery".致编辑的一封信:关于“颞下颌关节开放手术的耳轮根部与耳屏间切迹切口(RHITNI)”
Int J Surg. 2020 Nov;83:233-234. doi: 10.1016/j.ijsu.2020.09.051. Epub 2020 Oct 3.
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Imaging modalities for temporomandibular joint disorders: an update.颞下颌关节紊乱病的影像学检查方法:最新进展
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Prevalence of Posterior Disc Displacement of the Temporomandibular Joint in Patients with Temporomandibular Disorders: Systematic Review and Meta-Analyses.
颞下颌关节紊乱病患者的颞下颌关节盘后移位患病率:系统评价和荟萃分析。
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Three-dimensional finite element analysis of cartilaginous tissues in human temporomandibular joint during prolonged clenching.人颞下颌关节在长时间紧咬牙时软骨组织的三维有限元分析。
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Temporomandibular joint morphology and disc position in skeletal class III patients.骨性III类患者的颞下颌关节形态及盘位置
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Posterior disc displacement in the temporomandibular joint.颞下颌关节盘后移位
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Classification and prevalence of temporomandibular joint disk displacement in patients and symptom-free volunteers.颞下颌关节盘移位在患者及无症状志愿者中的分类与患病率
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Posterior dislocation of the temporomandibular disc.颞下颌关节盘后脱位
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