两种颌后入路治疗下颌骨髁突骨折方法的研究

Comparative Study of Two Retromandibular Approaches for Reduction of Condylar Neck Fracture

目的:探讨两种颌后入路治疗下颌骨髁突颈骨折的治疗方法及效果。方法:64例成人下颌骨中低位髁突颈骨折患者,随机分为A、B两组,经颌后入路,分别采用腮腺前缘入路及横断腮腺入路,解剖复位髁突骨折行坚强内固定术。结果:64例患者均取得良好解剖复位,咬合关系恢复良好,无关节强直出现。A组2例出现面神经麻痹。B组2例出现涎瘘,4例出现面神经麻痹症状。结论:颌后入路可有效治疗髁突骨折,且腮腺前缘入路较横断腮腺入路减少了手术并发症的发生。

Objective： To compare two retromandibular approaches for reduction of mandibular condyle neck frac- ture. Methods： 64 adult patients were included in this study and were randomly divided into grohp A and group B. Group A included 32 patients who were treated with retromandibular transparotid approach. Group B included 32 patients who were treated with retromandihular antero-parotid approach. Results： All 64 cases achieved satisfacto- ry anatomic reduction and occlusal relationship. No ankylosis of temporomandibular joint was found in all patients. In group A, two patients had facial nerve injury after surgery, while in group B four patients got facial nerve injury and two got salivary fistula. Conclusion： Retromandibular approach was effective in condyle neck fracture reduction. Compared with transparotid approach, antero-parotid approach reduced the surgical complications.