华西口腔医学杂志 ›› 2018, Vol. 36 ›› Issue (3): 262-266.doi: 10.7518/hxkq.2018.03.006

• 临床研究 • 上一篇    下一篇

颞下颌关节脱位手术治疗的回顾性研究

乔永明(), 刘一鸣, 李锐, 龚建民, 何巍   

  1. 郑州大学第一附属医院口腔医学中心口腔颌面外科,郑州 450052
  • 收稿日期:2017-07-04 修回日期:2018-02-08 出版日期:2018-06-01 发布日期:2018-06-01
  • 作者简介:

    乔永明,副主任医师,硕士,E-mail:hnymqiao@aliyun.com

  • 基金资助:
    河南省科技厅基金(142300410307);河南省卫生厅基金(2011020020);河南省教育厅基金(17A320054)

Retrospective study of temporomandibular joint dislocation by surgical treatment

Yongming Qiao(), Yiming Liu, Rui Li, Jianmin Gong, Wei He   

  1. Dept. of Oral and Maxillofacial Surgery, the Stomatology Center of the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Received:2017-07-04 Revised:2018-02-08 Online:2018-06-01 Published:2018-06-01
  • Supported by:
    The Fund of Henan Provincial Department of Science and Technology (142300410307);The Fund of Henan Provincial Department of Health (2011020020);The Fund of Henan Provincial Department of Education (17A320054).

摘要:

目的 回顾分析颞下颌关节脱位的手术治疗病例,评价其治疗效果。方法 选择2012年5月—2016年4月间收治的颞下颌关节脱位患者17例,包括陈旧性脱位(ID)8例和习惯性脱位(RD)9例。分别进行关节镜下滑膜下硬化剂注射术5例9侧,钛板植入关节结节增高术7例12侧,髂骨移植关节结节增高术1例1侧,Medpore植入关节结节增高术3例6侧,关节结节切除术1例2侧。术后1~5年随访,统计各手术方法的成功率。结果 关节镜下滑膜硬化术的治愈率为 77.8%(7/9),有效率100%;钛板植入关节结节增高术治愈率75%(9/12),有效率100%;Medpore植入关节结节增高术的治愈率为100%(6/6),髂骨移植关节结节增高术和关节结节切除术均治愈(1/1,2/2)。结论 应根据病情轻重来选择术式,对手术后复发者可选用Medpore植入关节结节增高术,该术式疗效确切,创伤相对较小、操作较简单。

关键词: 颞下颌关节脱位, 手术治疗, 回顾性研究

Abstract:

Objective This study aimed to retrospectively analyze temporomandibular joint dislocation by surgical treat-ment and evaluate the treatment effect. Methods From May 2012 to April 2016, a total of 17 cases of temporomandibular joint dislocation were surgically treated, including 8 cases of irreducible dislocation (ID) and 9 cases of recurrent dislocation (RD). Synovial injection of sclerosing agent by arthroscope was performed in 5 cases, 9 sides; augmentation of the articular eminence by titanium plate implantation was performed in 7 cases, 12 sides; iliac bone transplantation was performed in 1 case, 1 side; Medpore implantation was performed in 3 cases, 6 sides; and eminectomy and capsular tightening were performed in 1 case, 2 sides. Follow-up was conducted 1-5 years after the operation, and the success rate statistics was obtained. Results The cure rate of synovial injection of sclerosing agent by arthroscope was 77.8% (7/9), and the effective rate was 100%. The cure rate of titanium plate implantation was 75% (9/12), and the effective rate was 100%. The cure rates of augmentation of the articular eminence by Medpore implantation (6/6), iliac bone graft (1/1), and eminectomy (2/2) were 100%. Conclusion The surgical method of temporomandibular joint dislocation was selected according to the state of the patients. The postope-rative recurrent patients were advised to undergo augmentation of the articular eminence by Medpore implantation, which offered a reduced chance of recurrence and relatively less injury, as well as a simple operative method.

Key words: temporomandibular joint dislocation, surgical treatment, retrospective study

中图分类号: