内镜辅助下经口内入路治疗下颌骨髁突囊内骨折的临床研究

Clinical research on treatment of diacapitular condylar fractures of the mandible with transoral endoscopic-assisted approach

目的探讨内镜辅助下经口内入路治疗髁突囊内骨折的疗效。方法对24例(30侧)髁突囊内骨折行内镜辅助下经口内入路治疗,术后行临床功能检查和影像学评价。结果内镜辅助下经口内入路治疗下颌骨髁突囊内骨折患者24例,术后平均最大张口度(40.3±3.4)mm,患侧向运动度(8.0±1.6)mm,健侧向运动度(5.8±1.5)mm,前伸运动度(6.1±1.1)mm,无面神经和下牙槽神经损伤症状,无面部瘢痕,咬合关系基本恢复。1例出现关节弹响,5例大张口运动轻度疼痛。影像学检查术后下颌升支高度无明显下降,髁突改建良好,无髁突吸收、关节强直等严重并发症。结论内镜辅助下经口内入路治疗髁突囊内骨折是一种有效的方法。

Objective To investigate the effects of treatment with transoral endoscopic-assisted approach in diacapitu- lar condylar fractures. Methods Twenty-four patients with diacapitular condylar fractures were treated with transoral en- doscopic-assisted approach, curative effect were evaluated clinically and radiographically. Results Twenty-four patients with diacapitular condylar fractures were operated by transoral endoscopic-assisted approach, During the follow-up period, clinical function evaluationshowed the mean maximal mouth opening was （40.3± 3.4） ram, mandibular laterotrusion in the fractured side was （ 8.0 ± 1.6） mm, mandibular laterotrusion in the healthy side was （5.8 ± 1.5 ） mm and protrusion with a mean of （6.1 ± 1.1 ） mm. No injury of the facial nerve and the alveolar nerve or visible scars were observed. Oc- clusions were recovered well. One case sufferedfrom joint clicking and 5 cases with mild pain during wild opening were observed. Radiologiea] findings showed well condylar remodeling. No significant loss of ramus height and no severe re- sorption of condylar head and ankylosis of temporumandibu]ar joint were found. Conclusions Transoral endoscopic-as- sisted surgical approach is one of the most effective approaches to treat diacapitular condylar fractures.