髁颈下骨折切开复位时两种解剖面神经方法的比较

发布时间：2018-04-28 11:52

  本文选题：髁颈下骨折 + 面神经解剖　； 参考：《口腔颌面外科杂志》2015年06期

【摘要】：目的:在用改良切口行下颌骨髁颈下骨折切开复位坚固内固定手术时,比较顺行和逆行2种方法解剖面神经的效果。方法:2010-06—2014-12期间收治了36例患者(均为单侧髁颈下骨折),均在三明市第一医院口腔颌面外科,采用改良切口行下颌骨髁颈下骨折切开复位坚固内固定术。其中有11例使用顺行面神经解剖方法(顺行组),有25例使用逆行面神经解剖方法 (逆行组),对比两组的双钛板固定情况和术后的面神经的损伤、涎漏方面的数据。结果:两组在双钛板固定方面有显著差异(P=0.023)。在顺行组中,有8例为双钛板固定,3例只固定1块钛板;在逆行组中,25例全部为双钛板固定。两组在面神经损伤方面差异有统计学意义(P=0.020),在顺行组中暂时性面瘫7例,而在逆行组中暂时性面瘫有5例,两组均无永久性面瘫。在术后涎漏方面差异有统计学意义(P=0.023),顺行组术后发生涎漏4例,而在逆行组发生涎漏的只有1例。结论:用改良切口行下颌骨髁颈下骨折切开复位坚固内固定手术时,逆行性面神经解剖法更好。
[Abstract]:Objective: to compare the effect of anterograde and retrograde dissection of facial nerve during open reduction and rigid internal fixation of mandibular condylar and cervical fractures with modified incision. Methods Thirty-six patients (all unilateral subcondylar and subcondylar fractures) were treated by the modified incision in oral and maxillofacial surgery of Sanming first Hospital in the period of 2010-06-2014-12. Open reduction and rigid internal fixation of subcondylar and cervical fractures of the mandible were performed by modified incision. Among them, 11 cases were dissected by antegrade facial nerve method (anterograde group) and 25 cases by retrograde facial nerve dissection (retrograde group). The data of bilateral titanium plate fixation, facial nerve injury and salivary leakage were compared between the two groups. Results: there was significant difference between the two groups in double titanium plate fixation. In the anterograde group, there were 8 cases with double titanium plate fixation, 3 cases with only one titanium plate, and 25 cases with retrograde group with double titanium plate fixation. The difference between the two groups in facial nerve injury was statistically significant. In the anterograde group, 7 cases were temporary facial paralysis, while in retrograde group there were 5 cases of temporary facial paralysis. There was no permanent facial paralysis in both groups. The difference in postoperative salivary leakage was statistically significant (P < 0.023). In the anterograde group, there were 4 cases of coveal leakage, but only 1 case in the retrograde group. Conclusion: the retrograde facial nerve anatomic method is better in the open reduction and rigid internal fixation of mandibular condylar and cervical fractures with modified incision.
【作者单位】： 福建医科大学附属三明市第一医院口腔颌面外科;
【分类号】：R782.4;R322
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本文编号：1815171