经腮腺入路复位固定下颌骨骨折

Transparotid approach for open reduction and internal fixation of mandibular fractures

目的:探讨经腮腺入路行髁突低位骨折和下颌支骨折切开复位内固定的可行性。方法:对22例低位髁突骨折和4例下颌支骨折采用经腮腺入路行切开复位内固定术。结果:26例(100%)均使用2块接骨板固定,26(100%)例咬合关系基本恢复到伤前情况,术后开口度26～48mm(平均38.3mm)。2例(8%)出现面神经颊支损伤症状,3个月内均恢复正常,未出现面神经永久损伤病例及涎漏等并发症。结论:经腮腺入路行髁突低位骨折和下颌支骨折解剖复位坚强内固定,视野暴露好,复位固定可靠,面神经损伤较少。

PURPOSE： To study the feasibility of transparotid approach for open reduction and internal fixation of mandibular fractures. METHODS： Twenty-two patients with lower condylar fractures and four with mandibular ramus fractures were treated with transparotid approach for open reduction and internal fixation. RESULTS： Twenty-slx patients （100%）fixed with two plates, postoperative occlusion recovered to the pretraumatic condition and postoperative maximal mouth opening was 26-48mm （mean 38.3 mm）. Temporary weakness of the buccal branch of facial nerve occurred in 2 patients （8%）, but this resolved in all cases within 3 months and there was no case of permanent nerve injury. 26 patiens （100%） had no salivary fistulae. CONCLUSIONS： The method of transparotid approach for open reduction and internal fixation of lower condylar fractures and mandibular ramus fractures provides better visual field, accurate reduction and stable fixation and less injury of facial nerve.