耳垂前小切口穿腮腺进路在髁突中低位骨折中的应用

Transparotid approach through small incision in anterior earlobe in the treatment of middle and lower fracture of mandibular condyle

探讨耳垂前小切口穿腮腺进路在中低位髁突骨折内固定中的应用,评价其可行性。选择2018年10月—2019年10月,我科收治的10例下颌骨中低位髁突骨折伴脱位患者,用耳垂前小切口穿腮腺进路暴露下颌骨髁突中低位骨折进行内固定,观察有无面神经主干及分支的损伤,有无涎瘘发生,及观察术后张口度、咬合关系恢复情况。10例患者中,全部术区伤口均属于一期愈合,未出现涎瘘。1例出现暂时性闭眼不全的症状,加用甲钴胺及地塞米松治疗后逐渐恢复正常。所有病例手术切口小,瘢痕隐蔽,美观效果好,术后开口度及咬合关系恢复正常。耳垂前小切口穿腮腺入路行下颌骨中低位髁突骨折内固定术,手术切口范围小,美容效果好,能直视下行下颌骨髁突骨折复位内固定,并发症少,手术效果满意,值得临床推广应用。

To investigate the application of transparotid approach with small incision in front of earlobe in internal fixation of middle and lower condylar fracture.Between October 2018 and October 2019,10 patients with middle and lower condyle fracture were admitted to Meizhou Municipal People's Hospital Department of Stomatology.Internal fixation was performed by transparotid approach through small incision of the earlobe to expose the condylar fracture site of the mandible.To assess whether the facial nerve injury,salivary fistula,disturbance of mouth opening,and malformation of occlusal relationship were associated with the fracture.All patients made an uneventful recovery and healing with first intention.One patient presented with temporary difficult with eye closure,which gradually returned to normal after treatment with mecobalamine.In all cases,the incisions were small,scars were hidden,and the aesthetic effects were nice.Through the parotid gland approach,the small vertical incision,internal fixation of the lower mandibular condylar fracture was performed.The surgical procedure demonstrated fewer complications,and was worthy of clinical promotion and application.