下颌骨缺损整复后颞下颌关节的变化

Changes of Temporomandibular Joint After Mandibular Reconstruction.

目的 :观察单侧或部分下颌骨缺损重建术后升支高度和下颌骨髁状突运动的变化。材料和方法 :30例患者按手术方式的不同分为两组 ,A组为保留髁状突的下颌骨部分切除、自体骨移植或病变骨冷冻再植整复组 ,B组为未保留髁状突组 ,术后通过X线检查评价结果。结果 :所有患者手术后都表现有不同程度的髁状突运动障碍。主要有升支高度降低、髁状突水平运动和转动能力降低 ,且A、B两组间存在明显差别 ,B组改变大于A组。结论 :下颌骨缺损重建对颞下颌关节结构和功能具有一定的影响 ,保留髁状突时所受影响要明显小于未保留髁状突组。

Objective:The purpose of this study is to observe the changes of ramus height and condylar movement after mandibular reconstruction.Materials and Methods:Thirty patients were classified into 2 groups:group A,partial mandibulectomy and mandibular reconstruction not including the condyle,and group B,mandibular reconstruction including the condyle.The postoperactive results were evaluated by measurement of condylar motion on the radiograph.Results:All patients in this study were found having limitation of condylar mobility,including ramus height decrease, limited condylar horizontal motion and condylar rotation.Patients in group B had significantly greater decrease of mobility than those in group A.Conclusions:Mandibular reconstruction affected the function of temporomandibular joint,which is less in patients of the condyle retained than in those of the condyle not retained.Therefore, retaining condyle may benefit the function of TMJ after surgery. [