Nitzan D W, Bar-Ziv J, Shteyer A
Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah Schools of Dental Medicine and Medicine, Jerusalem, Israel.
J Oral Maxillofac Surg. 1998 Oct;56(10):1133-8; discussion 1139. doi: 10.1016/s0278-2391(98)90753-4.
This article proposes a hypothesis regarding the value of saving the fractured condyle and disc in their displaced position in ankylosis type III for optimal temporomandibular joint (TMJ) function and growth, and describes four cases treated in this manner.
Four patients (three females and one male, 9 to 48 years old) with TMJ ankylosis type III of 3 to 8 years' duration, a maximal mouth opening of 15 to 19 mm, and severely limited lateral and protrusive movements were treated. The ankylosed sites were resected, leaving the displaced condyle and disc in their medial position.
Fifteen to 60 months after surgery, the patients had a maximal mouth opening of 44 to 50 mm, as well as better contralateral and protrusive movements. In addition, two young patients (9 and 11 years old) showed an improved facial symmetry.
Treatment of patients with type III TMJ ankylosis should involve retention rather than removal of the displaced condyle and disc. The condyle and disc are left untouched in their precarious medial position so as to provide normal function and growth.
本文提出一个关于在III型关节强直中保留移位的髁突和关节盘以实现颞下颌关节（TMJ）最佳功能和生长价值的假说，并描述了4例采用这种方式治疗的病例。
治疗4例TMJ III型关节强直患者（3例女性，1例男性，年龄9至48岁），病程3至8年，最大开口度为15至19mm，侧向和前伸运动严重受限。切除强直部位，将移位的髁突和关节盘留在其内侧位置。
术后15至60个月，患者最大开口度达到44至50mm，对侧运动和前伸运动也有所改善。此外, 2例年轻患者（9岁和11岁）面部对称性得到改善。
III型TMJ关节强直患者的治疗应保留而非去除移位的髁突和关节盘。髁突和关节盘留在不稳定的内侧位置不予处理，以实现正常功能和生长。
