下颌后越腮腺前缘穿咬肌入路治疗髁突低位骨折的临床研究

发布时间：2018-11-09 17:09

【摘要】：目的:探讨下颌后越腮腺前缘穿咬肌入路在髁突低位骨折手术中的应用。方法:利用5具国人成人男性标本,对颞下颌关节及腮腺区解剖进行观察。结合局部解剖,对18例髁突低位骨折患者采用下颌后越腮腺前缘穿咬肌入路,切开皮肤及皮下组织达腮腺筋膜表面,沿腮腺筋膜表面向前解剖分离到腮腺前缘,将腮腺组织向后牵开显露咬肌表面,钝分离咬肌,暴露骨折断端,用一块L型钛板复位固定骨折。结果:18例患者术后咬合关系恢复良好,张口度正常,无1例患者出现面瘫。术后3个月复诊骨折愈合良好。结论:对于髁突低位骨折,应用下颌后越腮腺穿咬肌入路,操作简单,创伤小,利于保护面神经,术野清晰,便于复位固定。且切口隐蔽,术后瘢痕不明显。熟知颞下颌关节及腮腺区的解剖可明显减少手术创伤及预防手术并发症的发生。
[Abstract]:Objective: to investigate the application of anterior perforating masseter approach to lower condylar fracture. Methods: the anatomy of temporomandibular joint and parotid gland was observed in 5 adult Chinese male specimens. Combined with local anatomy, 18 patients with low condylar fracture were treated by the anterior perforating masseter approach of the anterior edge of the parotid gland after the mandible. The skin and subcutaneous tissue were cut to the surface of the parotid fascia and dissected to the anterior edge of the parotid gland along the surface of the parotid fascia. The parotid gland tissue was pulled backward to expose the masseter muscle surface, obtuse the masseter muscle, exposed the broken end of the fracture, and fixed the fracture with a L-type titanium plate. Results: the occlusal relationship of 18 patients recovered well, the degree of mouth opening was normal, and no case had facial paralysis. The fracture healed well 3 months after operation. Conclusion: for the lower condylar fracture, the operation is simple, the trauma is small, the operation field is clear and the fixation is convenient. The incision was concealed and the scar was not obvious after operation. Knowing the anatomy of temporomandibular joint and parotid gland can reduce surgical trauma and prevent complications.
【作者单位】：昆明医科大学附属口腔医院口腔颌面外科;昆明医科大学人体解剖教研室;
【基金】：云南省医疗卫生单位内设研究机构科研项目(编号:2016NS115)
【分类号】：R782.4

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