改良式尾侧下颌骨节段性切除术治疗猫颞下颌关节强直效果的回顾性分析

Retrospective Analysis of the Effects of Modified Segmental Resection of Caudal Mandible in the Treatment of Cat Temporomandibular Joint Ankylosis

为了探讨猫颞下颌关节强直的临床发病特点、手术方法、并发症和手术效果,本文回顾性分析了在中国农业大学教学动物医院就诊的8只颞下颌关节强直患猫的病历,结合电话回访评估手术并发症和手术效果。结果显示,8只患猫均进行了电子计算机断层扫描(CT)检查,其中4只(3只单侧和1只双侧)诊断为假性强直,另外4只(2只单侧和2只双侧)诊断为真性强直;5只(3只单侧和2只双侧)进行了改良式尾侧下颌骨节段性切除术,3只(2只单侧和1只双侧)放弃治疗;进行手术的5只患猫术后口腔打开角度均良好,其中1只(单侧)因苏醒质量较差选择了安乐死。长期随访(随访时间7个月~5年,平均约25个月)结果显示,单侧强直的2只患猫手术效果良好,双侧强直的2只患猫手术效果较差,未手术的3只患猫因无法进食而安乐死。结果表明,颞下颌关节强直患猫应该进行手术治疗。改良式尾侧下颌骨节段性切除术可以替代关节成形术、关节外骨切除术和尾侧下颌骨节段性切除术,达到相似的手术效果,并可以降低关节周围医源性神经和血管损伤或牙齿损伤的风险;改良式尾侧下颌骨节段性切除术对于单侧颞下颌关节强直的患猫治疗效果较好,而对于双侧颞下颌关节强直的患猫治疗效果不理想。

This study aims to explore the clinical features,surgical methods,complications,and outcomes of temporomandibular joint ankylosis in cats.A retrospective analysis of medical records from eight cats diagnosed with temporomandibular joint ankylosis at the China Agricultural University Veterinary Teaching Hospital was conducted.Follow-up evaluations were performed via telephone to assess surgical complications and outcomes.The results showed that all eight cats underwent computed tomography(CT)scans,with four diagnosed with pseudoankylosis(three unilateral,one bilateral)and four with true ankylosis(two unilateral,two bilateral).Five cats(three unilateral,two bilateral)underwent modified segmental resection of caudal mandible,while three(two unilateral,one bilateral)were not treated.Postoperatively,all five surgically treated cats exhibited good mouth opening angles;however,one unilateral case was euthanized due to poor recovery quality.Long-term follow-up(ranging from 7 months to 5 years,with an average of 25 months)indicated that the two unilateral cases had good outcomes,while the two bilateral cases had poor outcomes.The three untreated cats were euthanized due to an inability to eat.These findings suggest that surgical intervention is necessary for cats with temporomandibular joint ankylosis.Modified segmental resection of caudal mandible can be an effective alternative to arthroplasty,extra-articular osteotomy,and caudal mandibular segmental resection,offering similar surgical outcomes while reducing the risk of peri-articular iatrogenic neurovascular injury or dental injury.This procedure is more effective for treating unilateral temporomandibular joint ankylosis in cats but less effective for bilateral cases.