状突冷冻再植后颞下颌关节改变的实验研究

The changes of temporomandibular joint following reimplantaion of freeze-treated mandibular condyles.

目的 :为颞下颌关节肿瘤的治疗及关节重建提供一定的理论依据。材料和方法 :对 16只未成年日本大耳白兔的右侧髁状突施行了冷冻再植术。术后所有动物正常存活 ,第 2、4、8、12周分别处死 4只动物。采用常规组织学、扫描电镜及微血管显像等对髁状突和关节盘进行观察。结果 :组织学检查发现随着血供逐渐恢复 ,失去活力的骨被新骨“爬行替代” ,而髁状突软骨的结构未完全恢复 ;扫描电镜检查证明了关节盘下腔面的表面结构基本正常 ,实验后期髁状突的表面较光滑 ,但无明显胶冻样物 ;微血管显像显示冷冻再植髁状突逐渐再血管化。 16只动物中有 3只的手术侧颞下颌关节发生轻度粘连。结论这些结果证明 :髁状突冷冻再植在颞下颌关节重建时有应用的可行性。

Objective:This study was undertook to provide one of the rationale for reconstruction of temporomandibular joint suffering from tumor. Materials and Methods: Sixteen juvenile Japanese large ear rabbits were used in this study. The right mandibular condyles of the animals were resected, freeze-treated and reimplantated. All the animals survived without postoperative complications. The animals were sacrificed at the 2, 4, 8 and 12 weeks after the operation, respectively, and each group included four animals. Condyles and discs were examined by histopathology, scanning electron microscopy and microangiography. Results: The histologic examination exhibited creeping substitution of the newly formed bone for devitalized bone and incomplete reconstruction of the condylar cartilage layers as the implanted condyles were gradually revascularized. The scanning electron microscopy examination displayed no significant changes of the inferior surface of the discs, and smoother surface of the condyles with a little gelatinous substance at the later period of the experiment. Slight fibrous adhesions between the disc and condyle of the operated side occurred in three animals. The microangiography demonstrated the revasularization of the frozen and reimplanted condyles. Conclusion: These results indicate that the technique in this experiment is practicable for reconstruction of the temporomadibular joint.