颅面分离的外科治疗

Diagnosis and treatment of craniofacial dissociation

目的 探讨颅面分离的诊断与外科治疗。方法 回顾性研究1995年10月～2000年10月间诊治的颅面分离患者28例病人的临床资料和外科治疗方法。结果 28例病人中21例为外伤性颅面分离，8例为非外伤性颅面分离。外伤有眼眶并发症者37例次，颅内并发症者29例次，其中脑脊液鼻漏占42．9％。外伤骨折复位固定术式为经面部创口进路者9例，经面中部掀翻进路4例，颅面联合进路4例，多切口骨膜下隧道贯通进路4例。非外伤性颅面分离者均在切除颅底沟通瘸时一期进行了颅面骨的固定与颅面分离的修复。结论 颅面分离是颅面外科一种特殊类型疾病，采用适宜的外科手术方法进行治疗，能够取得良好的治疗效果。

Objective It is purpose to analysis diagnosis and treatment of craniofacial dissociation. Methods It was analysis that the clinical data of 28 patients with craniofacial dissociation between 1995 and 2001. Results The types of craniofacial dissociation included traumatic craniofacial dissociation in 21 patients and non--traumatic craniofacial dissociation in 7 patients. In 21 patients with traumatic craniofacial dissociation, 11 patients incorporated with zygoma fracture, 6 cases with mandible fracture, 8 cases with other fracture,37 instances with orbit complication,29 instances with intracranial complication. The surgical method of reposition of bone fracture included transfacial wound（9 cases） and transmidfacial approach（4 cases） and craniofacial approach （4 cases） and multi incision subperiosteum tunnel approach（4 cases）. With performed skull base surgery, the 7 patients with non--traumatic craniofacial dissociation were primary repaired. Conclusions Craniofacial dissociation is special diseases in craniofacial surgery. The good outcome can be achieved by using appropriate surgical approach.