下颌骨升支后1/3倒植治疗颞颌关节强直

Inverted Posterior One-third of Ramus Grafting in Treatment of TMJ Ankylosis

用升支后1/3骨片倒置移植治疗颞颌关节强直11例(13侧),其中10例7～15岁。6例随访14个月以上,1例复发,5例开口度(切牙间距)达到2.2～3.3m。该法只用一个切口,就近取骨,方法简单。用下颌角取代关节头,保留部分嚼肌和翼内肌附着,保持升支的高度,解剖形态接近正常,还可防止术后复发和开(牙合),具有临床实用价值。

Eleven cases of TMJ ankylosis were treated with inverted posterior one-third segment of ascending ramus grafting.Ten of them ranged from 7 to 15 years of age.There was no openbitc after operation. Six patients were followed up for more than 14 months.One recurred 10 months postoperatively,and the others got incisal opening from 2.2 to 3.3 centimeters.This method used only one incision and drew on local bone without any other trauma to the body.It is easier than the coronoid process grafting.The original angle of mandible with a part of masseter and medial pterygoid muscles insertion functions as condyle,which is also similar to the normal anatomy of TMJ.Still more,since the height of ascending ramus was still maintained,it may avoid the openbite.