经耳前腮腺小切口径路治疗髁突中位骨折

Premenstrual ears parotid incision approach in the treatment of mandibular condylar fractures

目的：探讨经耳前腮腺径路治疗髁突中位骨折的方法。方法：回顾性分析经耳前腮腺径路治疗髁突中位骨折26例35侧的临床资料,记录术前、术后的腮腺涎漏、张口受限程度、面神经损伤及咬合紊乱等情况,通过术前、术后曲面断层片评估骨折复位与愈合状况。结果：全部病例手术过程顺利。手术时间平均（1.5±0.3）h;伤口一期愈合;全部病例均获得良好的咬合关系;3例出现涎瘘,经加压包扎后治愈;张口度恢复至3.5 cm。术后1~3个月复查曲面断层片显示骨折复位及愈合良好;4例出现暂时性面瘫,术后3~6个月复查面瘫症状消失。结论：经耳前腮腺小切口径路治疗髁突中位骨折可获得满意效果。

Objective：To evaluate the effects of pre-auricular parotid gland approach in the treatment of mandibular condylar neck fracture. Method：Clinical data of patients with mandibular condylar neck fracture（26 patients,35 temporomandibular joints） were collected and analyzed retrospectively. The clinical information of pre-and post-operative parotid salivary fistula,limited mouth opening,facial nerve injury and malocclusion was recorded respectively. Meanwhile,pre- and post-operative panoramic images were used to evaluate the reductive and healing state of the fractures. Result：All the operations were uneventful,with an average operation time 1.5 hours,（mean ±SD,1.5 ±0.3）. The wound healed well and a good occlusion was achieved in all the patients. Parotid salivary fistula occurred in 3 patients after operation,but disappeared after pressure dressing. A mouth opening over 3.5cm was achieved in all the patients. The post-operative panoramic images（1~3 months later） showed the fracture reduction and healing was good. Facial paralysis occurred in four patients after operation,but disappeared 3~6 months later. Conclusion：The effects of pre-auricular parotid gland approach in the treatment of mandibular condylar neck fracture are satisfactory.