颞下颌关节疾病的外科治疗

Surgical Management of Temporomandibular Joint Disease

颞下颌关节疾病(temporomandibular joint disease,TMD)包括颞下颌关节紊乱病、颞下颌关节损伤、颞下颌关节脱位、颞下颌关节强直、先天性或后天性畸形、炎性疾病以及肿瘤等,治疗方法有保守治疗和外科治疗。基础研究有助于了解颞下颌关节疾病的致病机理,并为颞下颌关节疾病的治疗提供理论依据。虽然颞下颌关节疾病的治疗多年来存在争议,但随着对颞下颌关节疾病了解的加深,以及影像学的发展、关节镜和手术方法的改进,颞下颌关节疾病的外科治疗有了明显进步。本文对颞下颌关节紊乱病、颞下颌关节脱位、髁突骨折、颞下颌关节强直、先天性或后天性畸形以及肿瘤等颞下颌关节疾病的外科治疗现况及进展进行了阐述。

A variety of disorders affect temporonmndibular joint （TMJ） including temporomandibular disorders （TMD）, trauma, dislocations, ankylosls, congenital and growth abnormalities, infections and tumors. Temporomandibular joint diseases shouhl be managed by conservative treatment and/or surgical treatment. Aehievements in basic researt.h has led to an improved understandiug of the etiology and pathogenesis of TMJ disease,which, in turn, has provided critical support for the role of the managemen! of TMJ disease. Controversies still exist. Through the further understanding of TMJ pathology, modified diagnostic imaging, TMJ arthroseopy and sophisticated surgical techniques, the more reliable and practical of TMJ surgery has been enhanced.