关节灌洗加透明质酸治疗不可复性关节盘前移位

Arthrocentesis and Lavage and Hyaluronate of TMJ for the treatment of anterior disc displacement without reduction

目的 探讨颞颌关节不可复性盘前移引起的严重张口受限的非手术疗法。方法 对 5 9例不可复性盘前移 (包括 3 6例旋转移位 )的张口受限患者 ,行多次关节灌洗 ,配合木楔被动张口训练 ,透明质酸腔内注射治疗。结果 经 3次治疗后颞颌关节活动度明显增大 (P <0 .0 1)。基本无痛 ,无并发症。关节造影显示 :仅 3例关节盘部分复位。结论 该法操作简单 ,可反复进行 ,是治疗不可复性盘前移 (包括旋转移位 )引起张口受限的有效方法。

Objective To study the Non Operative treatment of a severe, limited mouth opening by anterior disc displacement without reduction of the TMJ. Methods 59 patients with limited mouth opening caused by anterior disc displacement without reduction (conclude 36 patients with rotatory disc displacement) Were treated by using TMJ arthro centesis and Lavage and the passive exercise opening mouth wooden gag and Hyaluronate injected. Results after 2～3 times treatments mouth opening degree had significantly improved ( P < 0.01 ). No pain and complication had been observed . Arthrography revealed that most of the TMJs studied had persisten anterior disc displacement with only 3 patients demonstrating a 'reduced disc'. Conclusion It is a simplified treatment for severe limited mouth opening caused by anterior and rotatory disc displacement