陈旧性颧骨颧弓骨折致重度张口受限的手术治疗

Surgical treatment of severe trismus caused by olden zygomatic arch fracture

目的:回顾总结陈旧性颧骨颧弓骨折致重度张口受限的手术方法及效果。方法:2007～2012年我科收治的陈旧性颧骨颧弓骨折致重度张口受限患者42例。采用头皮冠状切口联合口内上颌龈颊沟切口入路松解颧骨颧弓下方及喙突局部瘢痕组织,解除喙突局部压迫,同期切除喙突再行骨折复位内固定术,术后加强张口训练,随访6个月～3年。结果:42例患者全麻清醒后其张口度均有不同程度改善,经张口训练1～3月后张口度均超过二横指,面部外形恢复良好,随访6个月～3年未见复发。结论:采用头皮冠状切口联合口内上颌龈颊沟切口入路松解颧骨颧弓下方及喙突局部瘢痕组织,解除喙突局部压迫,同期切除喙突再行骨折复位内固定术是治疗颧骨颧弓骨折致重度张口受限患者的一种较好的手术方法。

Objective To summary retrospectively the surgical method and effect of severe trismus caused by olden zygomatic arch fracture. Methods 42 patients were operated in our hospital from 2007 to 2012,which were released the pression of zygomatic zygomatic arch and coronoid process after released the local scar tissue of zygomatic zygomatic arch and coronoid process by the coronal and buccal groove incision.They were allowed to open mouth training and were followed up for 6 months to 3 years after operation. Results Their mouth opening were improved differently and more than two fingers and the Facial appearance was repaired complely. Conclusion It is better operation for severe trismus caused by olden zygomatic arch fracture to released the pression of zygomatic zygomatic arch and coronoid process after released the local scar tissue of zygomatic zygomatic arch and coronoid process by the coronal and buccal groove incision.