颞下颌关节疾病的外科手术治疗

Surgical Treatment of Temporomandibular Joint Disease.

目的 :颞下颌关节疾病的治疗包括保守治疗和外科手术治疗 ,本研究目的是探讨颞下颌关节疾病外科手术治疗的适应证以及手术方法。方法 :对 1988年至 2 0 0 0年共收治的 76 5例颞下颌关节疾病患者进行回顾性研究。其中颞下颌关节紊乱病患者共 4 18例 ,颞下颌关节外伤 15 9例 ,颞下颌关节强直 131例 ,髁状突肥大 38例 ,颞下颌关节肿瘤 18例 ,颞下颌关节感染 1例 ,其中 6 37例进行了外科手术治疗。结果 :颞下颌关节紊乱病患中 2 18例行颞下颌关节内窥镜术 ,2 1例行颞下颌关节盘复位术 ,91例行颞下颌关节盘修补术 ,11例行陈旧性关节脱位开放复位术 ;131例行颞下颌关节成形术 ;10 9例行髁状突骨折开放复位术 ;38例行髁状突截骨术和正颌手术 ;18例行颞下颌关节肿瘤切除术。结论 :颞下颌关节紊乱病、损伤、关节强直、肿瘤、畸形以及其他关节疾病的手术适应证范围在不断地扩大 ,颞下颌关节外科的手术方法也在不断地改良。

Objective:The treatment of temporomandibular joint(TMJ) disease include nonsurgical and surgical method, this study was to evaluate indication and method of surgical treatment of temporomandibular joint disease.Methods:A retrospective study of 765 patients with temporomandibular joint disease from 1988 to 2000.The temporomandibular joint disease including 418 cases of temporomandibular disorders,159 cases of trauma in TMJ,131 cases of ankylosis, 38 cases of condylar hyperplasia, 18 cases of tumors and one case of infection.Results:There were 637 patients who had been treated with surgical treatment including arthroscopic surgery (218 cases),repositioning the displaced disc(21 cases),repairing disc perforation (91 cases),open reduction of old dislocation of TMJ (11 cases);arthroplasty of TMJ (131 cases);open reduction of condylar fracture (109 cases);high condylectomy and orthognathic surgery (38 cases) and surgical extirpation of neoplasms in TMJ (18 cases).Conclusions:There are increased in the scope of indications of surgical treatment for temporomandibular disorders, trauma, ankylosis, tumors, deformity and other kind of diseases.The surgical methods for TMJ diseases are modified and developed to microsurgery and restore the function of TMJ.