改良切口锚固术在颞下颌关节盘不可复性前移位中的近期疗效

Short-term efficacy of modified temporomandibular joint disc anchor for anterior disc displacement without reduction

目的探究改良切口锚固术在颞下颌关节盘不可复性前移位(ADDWoR)中的近期疗效。方法选取本院收治的80例ADDWoR患者为研究对象,均行改良切口锚固术。术后随访3个月,根据MRI影像学表现评估关节盘复位效果,并于术前、术后1个月、术后3个月记录患者最大张口度(MMO)、右侧偏动距离(RLE)、左侧偏动距离(LLE)、下颌前伸距离(PE)等下颌运动功能指标,颞下颌关节紊乱指数(CMI)及疼痛视觉模拟量表(VAS)评分,并统计患者术后的满意度。结果80例患者中,45例患者复位效果为优,31例为良,优良率为95.00%。术前、术后1个月、术后3个月患者MMO、PE、RLE、LLE逐渐升高(P<0.05),VAS评分、CMI逐渐降低(P<0.05)。80例患者中,45例患者为非常满意,33例患者为基本满意,总满意度为97.50%。结论改良切口锚固术治疗ADDWoR可有效减轻患者术后疼痛,改善下颌运动功能,提高满意度,近期疗效较好。

Objective To investigate the short-term efficacy of modified temporomandibular joint disc anchor for anterior disc displace⁃ment without reduction(ADDWoR).Methods Eighty patients with ADDWoR in our hospital were included as the research subjects,and all patients were given modified temporomandibular joint disc anchor.The follow-up was conducted for 3 months,the reduction effect of the articular disc was evaluated according to the MRI imaging findings,and the mandibular motor function indicators including the maximum mouth opening(MMO),right lateral excurision(RLE),left lateral excurision(LLE),protrusion excusion(PE),craniomandibular index(CMI),and pain visual analogue scale(VAS)score before operation,1 month and 3 months after operation were recorded.The satisfaction of patients after operation was collected.Results Among the 80 patients,45 patients had excellent reduction effect and 31 patients had good reduction effect,with an excellent and good rate of 95.00%.The MMO,PE,RLE and LLE of the patients before operation,1 month and 3 months after operation gradually increased(P<0.05),while the VAS score and CMI gradually decreased(P<0.05).Among the 80 patients,45 patients were very satisfied,and 33 patients were basically satisfied,with a total satisfaction rate of 97.50%.Conclusion Modified temporomandibular joint disc anchor in the treatment of ADDWoR can effectively relieve postoperative pain of patients,ameliorate mandibular motor function,and enhance satisfaction,with a good short-term efficacy.