关节盘锚固定术治疗颞下颌关节盘前移位的临床应用

Application of disc anchorage in the treatment of anterior disc displacement without reduction

目的通过对不可复性盘前移位的患者行关节盘复位锚固定术,探讨关节盘锚固定术治疗不可复性盘前移位的疗效。方法对根据临床症状及磁共振成像诊断为不可复性盘前移位的患者15例(20侧关节)行关节盘锚固定术。结果 15例20侧关节接受关节盘复位固定术,手术后MRI显示12例16侧达到优,2例3侧达到良,有效率为95%,仅有1侧为"差",占5%。所有不可复性盘前移位患者术后3、6、12个月较术前的疼痛改善依次为90%、95%、90%,下颌最大侧向运动改善依次为0.4、3.2、5.9 mm,最大张口度改善依次为8.6、16.2、22 mm。结论关节盘锚固定术治疗不可复性盘前移位具有显著疗效。

Objective To investigate the clinical effect of Disc Anchorage for anterior disc displacement without reduction according to MRI. Methods Disc Anchorages were applied on 15 patients（ 20 sides） of Anterior disc displacement without reduction according to clinical symptoms and MRI. Results Postoperative MRI showed that among the 15 cases（ 20 sides） of Disc Anchorage,12 cases（ 16 sides） achieved excellent result,2 cases（ 3 sides） achieved good result,and the effective rate was 95%. Only 1 side was＂poor pressing＂,accounting for 5 %,which had longer course,serious deformation of TMJ disc morphology,and shortened length of disc. A clinical follow-up of all patients was carried out 3 months,6 months and 12 months after surgery,to compare the pain,mouth opening,degree of lateral movement changes before and after surgery. Conclusions Disc Anchorage has a significant effect on anterior disc displacement without reduction.