下颌角及升支部骨折的微创手术治疗

目的总结和分析口内切口联合用穿颊器的微创手术入路对下颌骨角部及升支骨折进行微型钛板坚强内固定的疗效。方法对30例下颌骨角部或升支部骨折采用口内切口联合用穿颊器经过颊部辅助小切口复位内固定;随机选取同时期另外16例同类型骨折采用传统口外入路手术的患者进行比较。结果两组病例都取得了良好的疗效,咬合关系恢复良好,但30例采用口内切口联合用穿颊器经过颊部辅助小切口复位内固定的损伤较小,患者无面神经损伤症状,表面皮肤无遗留明显的手术疤痕,更符合美学要求。结论通过口内切口联合穿颊的微创手术入路行坚强内固定治疗下颌骨角部和升支部骨折疗效可靠,美容效果良好。

Objective To evaluate the treatment with screwed miniplates through an intraoral and transoral approach for patients with angle and ramus fractures.Methods Thirty cases of mandibular angle and ramus fractures were treated by screwed miniplates placed through a transbuccal incision with transbuccal trocar instrumentation,randomly selected from the same period 16 cases of the same type of fracture the traditional extraoral approach were served as the cantrols.Results Two groups of patients have achieved good effect,occlusion and good recovery,30 cases treated by screwed miniplates placed through a transbuccal incision with transbuccal trocar instrumentation gained the better effects,the damage is small,patients with no facial nerve damage symptoms,the surface of the skin left no obvious scar.Conclusion Mandibular angle and ramus fractures treated by intraoral incision and intraoral approach can achieve reliable fixation and also has excellent cosmetic.