改良颞下颌关节盘锚固术常见并发症的防治

Prevention of common complications after modified temporomandibular joint disc anchor

目的:总结改良颞下颌关节盘锚固术常见并发症,探讨其产生的原因及防治方法。方法 :对2011年7月—2012年12月行改良颞下颌关节盘锚固术的441例患者进行术后随访。采用问卷调查收集资料,内容包括面神经损伤症状、术区麻木、味觉出汗综合征表现、外观及功能改变、瘢痕等。采用SPSS13.0软件包对数据进行统计学分析。结果:实际随访患者402例,随访率为91.16%。其中男72例,女330例;平均年龄(31.36±15.18)岁,平均随访(31.89±5.55)个月。改良锚固术的常见术后并发症包括闭眼困难(1.09%)、抬眉困难(6.74%)、额纹消失(1.28%)、上睑下垂(2.91%)、麻木(14.39%)、进食时关节区潮红、出汗(1.63%)、耳前区凹陷(5.28%)、局部脱发(0.18%)、开闭口紧绷感(7.47%)、咀嚼无力(5.10%)等。结论:颞下颌关节区解剖结构复杂,对术者要求较高,需经严格训练,方可尽量减少并发症的发生。

PURPOSE： To review and analyze the common complications after modified temporomandibular joint disc anchor, and explore the causes and prevention of postoperative complication. METHODS： The patients undergoing modified anchorage surgery were followed up since July 2011 to the December 2012. They were asked to fill in the postoperative questionnaire, which included symptoms of the facial nerve injury, numbness of the operation area,manifestations of gustatory sweating syndrome, changes of appearance and function, scar, and etc. The results were statistically analyzed using SPSS 13.0 software package. RESULTS： A total of 402 patients responded to the survey,including 72 males, 330 females, and the average age was（31.36 ±15.18） years. The common postoperative complications of modified temporomandibular joint disc anchoring operation included eyes closing difficulty（1.09%）, row lifting difficulty（6.74%）, disappearance of the wrinkles on the forehead（1.28%）, upper eyelid ptosis（2.91%）, numbness（14.39%）, gustatory sweating syndrome（1.63%）, preauricular area depression（5.28%）, local alopecia（0.18%）, a sense of tension during opening and closing mouth（7.47%）, weakness of chewing（5.10%） and etc. CONCLUSIONS： The temporomandibular joint is complicated anatomically, which makes easier for improper operation to cause a series of complications. Rich experience and higher operation skills are required for operators.