改良头皮冠状切口在颅颌面骨折手术中的应用

doi:10.7518/hxkq.2017.02.011

华西口腔医学杂志 ›› 2017, Vol. 35 ›› Issue (2): 167-170.doi: 10.7518/hxkq.2017.02.011

改良头皮冠状切口在颅颌面骨折手术中的应用

王雷¹(), 赵文杰¹, 孙黎波¹, 周航宇¹, 吴双江¹, 肖金刚^1,²()

1.西南医科大学附属口腔医院口腔颌面外科
2.口颌面修复重建和再生实验室,泸州 646000

收稿日期:2016-08-16 修回日期:2017-01-12 出版日期:2017-04-01 发布日期:2017-04-01
作者简介:
王雷,硕士,E-mail：1101875540@qq.com
基金资助:
国家自然科学基金（81371125）;四川省科技厅基金（20-14JY0044）;四川省教育厅基金（10ZB030）

Application of modified coronal approach in treatment of craniomaxillofacial fractures

Lei Wang¹(), Wenjie Zhao¹, Libo Sun¹, Hangyu Zhou¹, Shuangjiang Wu¹, Jingang Xiao^1,²()

1. Dept. of Oral and Maxillofacial Surgery, The Affiliated Stoma-tology Hospital of Southwest Medical University, Luzhou 646000, China
2. Orofacial Reconstruction and Regeneration Labo-ratory, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou 646000, China

Received:2016-08-16 Revised:2017-01-12 Online:2017-04-01 Published:2017-04-01
Supported by:
The National Natural Science Foundation of China (81371125);The Program of Sichuan Science and Technology Bureau (2014JY0044);The Project of Sichuan Provincial Department of Education (10ZB030)

摘要/Abstract

摘要：

目的探讨一种新的改良头皮冠状切口在颅颌面骨折手术中的应用价值。方法对37例颅颌面骨折患者采用改良头皮冠状切口进行颅颌面骨折的修复重建。术后对患者面神经功能状况、耳颞区形态、面形恢复、骨折复位、术区瘢痕等方面进行评价。结果术后随访6~36个月,37例患者均未出现面神经功能损伤和耳颞区凹陷,面形恢复良好,骨折端均实现解剖复位。切口瘢痕隐蔽,1例出现增生性瘢痕。结论改良头皮冠状切口可有效降低传统冠状切口所导致的颞区凹陷及面神经颞支损伤的发生,切口更隐蔽,未增加其他并发症的发生,值得临床推广。

关键词: 改良冠状切口, 颅颌面骨折, 手术路径, 面神经, 颞区

Abstract:

Objective This study aimed to investigate clinical efficacy of a modified coronal approach in treatment of craniomaxillofacial fractures. Methods Thirty-seven cases of craniomaxillofacial fractures underwent open reduction and rigid internal fixation through modified coronal approach. Clinical follow-up visits were conducted to evaluate facial nerve functional status, temporal shape, appearance restoration, and reduction of fracture and surgical area scars. Results During follow-up period of 6-36 months, appearance and function of all 37 patients recovered well without facial nerve injury and temporal depression deformity. All cases presented hidden scars, except for one case with hypertrophic scar. Conclusion Applying modified coronal approach to craniomaxillofacial surgery effectively reduces incidence of temporal depression and facial nerve injury compared with traditional approach. The modified coronal approach produced more subtle scars compared with traditional approach and should be applied to treatment of craniomaxillofacial fractures.

Key words: modified coronal approach, craniomaxillofacial fracture, operation route, facial nerve, temporal region

中图分类号:

R782.4

王雷, 赵文杰, 孙黎波, 周航宇, 吴双江, 肖金刚. 改良头皮冠状切口在颅颌面骨折手术中的应用[J]. 华西口腔医学杂志, 2017, 35(2): 167-170.

Lei Wang, Wenjie Zhao, Libo Sun, Hangyu Zhou, Shuangjiang Wu, Jingang Xiao. Application of modified coronal approach in treatment of craniomaxillofacial fractures[J]. West China Journal of Stomatology, 2017, 35(2): 167-170.

图/表 3

参考文献 12

[1]	Gabrielli MA, Monnazzi MS, Gabrielli MF, et al.Clinical evaluation of the bicoronal flap in the treatment of facial fractures. Retrospective study of 132 patients[J]. J Cranio-maxillofac Surg, 2012, 40(1):51-54.
[2]	Kummoona R.Management of maxillofacial injuries in Iraq[J]. J Craniofac Surg, 2011, 22(5):1561-1566.
[3]	Kleinberger AJ, Jumaily J, Spiegel JH.Safety of modified coronal approach with dissection deep to temporalis fascia for facial nerve preservation[J]. Otolaryngol Head Neck Surg, 2015, 152(4):655-660.
[4]	Zhuang QW, Zhang XP, Wang X, et al.Coronal approach to zygomaticomaxillary complex fractures[J]. Eur Rev Med Pharmacol Sci, 2015, 19(5):703-711.
[5]	Kenkere D, Srinath KS, Reddy M.Deep subfascial approach to the temporal area[J]. J Oral Maxillofac Surg, 2013, 71(2):382-388.
[6]	杨立娟, 柳春明, 滑文美, 等. 顺序复位固定技术治疗颧骨复合体骨折[J]. 中国修复重建外科杂志, 2013, 27(10):1181-1184.
	Yang LJ, Liu CM, Hua WM, et al.Sequential reduction and fixation for zygomatic complex fractures[J]. Chin J Repar Reconstr Surg, 2013, 27(10):1181-1184.
[7]	Gentile MA, Tellington AJ, Burke WJ, et al.Management of midface maxillofacial trauma[J]. Atlas Oral Maxillofac Surg Clin North Am, 2013, 21(1):69-95.
[8]	Olate S, Lima SM, Sawazaki R, et al.Variables related to surgical and nonsurgical treatment of zygomatic complex fracture[J]. J Craniofac Surg, 2011, 22(4):1200-1202.
[9]	Rajmohan S, Tauro D, Bagulkar B, et al. Coronal/hemico-ronal approach—A gateway to craniomaxillofacial region[J]. J Clin Diagn Res, 2015, 9(8):PC01-PC05.
[10]	Luo W, Wang L, Jing W, et al.A new coronal scalp technique to treat craniofacial fracture: the supratemporalis approach[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 113(2):177-182.
[11]	Baek RM, Heo CY, Lee SW.Temporal dissection technique that prevents temporal hollowing in coronal approach[J]. J Craniofac Surg, 2009, 20(3):748-751.
[12]	Lee EI, Mohan K, Koshy JC, et al.Optimizing the surgical management of zygomaticomaxillary complex fractures[J]. Semin Plast Surg, 2010, 24(4):389-397.

[1]	陈芸梅, 刘艳, 黄秋雨, 罗姜, 吴红梅, 王烨华, 吴玲, 李秀娥, 毕小琴. 周围性面瘫患者的面神经功能训练专家共识[J]. 华西口腔医学杂志, 2023, 41(6): 613-621.
[2]	唐辉, 王浪, 王雷, 饶鹏程, 罗道文, 付光新, 肖金刚. 改良耳屏缘切口腮腺前缘穿咬肌入路在髁突重建术中的应用[J]. 华西口腔医学杂志, 2023, 41(3): 290-296.
[3]	唐梦莹, 罗道文, 孙黎波, 周航宇, 吴双江, 付光新, 肖金刚. 改良下唇旁正中-颌下入路在上颌骨（次）全切除术中的应用[J]. 华西口腔医学杂志, 2020, 38(4): 380-384.
[4]	李浩,吴坡,蒋佶,赵潇黎,郑维银,羊书勇. 面神经中段解剖法在区域性腮腺切除术中的应用[J]. 华西口腔医学杂志, 2020, 38(1): 37-41.
[5]	赵丹,李月恒,杨正艳,蔡婷,吴晓艳,夏雨,周智. 干细胞局部应用对缺损面神经再生效果的系统评价[J]. 华西口腔医学杂志, 2020, 38(1): 59-68.
[6]	王雅楠, 黄艳丽, 迪力努尔·迪力夏提, 刘伟龙, 李蕙, 王怡, 刘磊. 头皮冠状切口颞肌上入路治疗眶颧骨折并发症研究[J]. 华西口腔医学杂志, 2017, 35(1): 73-76.
[7]	刘仔龙张国志. 腮腺内面神经鞘瘤的诊断与治疗[J]. 华西口腔医学杂志, 2015, 33(4): 431-435.
[8]	刘家武俞辉明邱长乐刘磊. 颅颌面骨折及伴发伤同期手术的临床研究[J]. 华西口腔医学杂志, 2014, 32(1): 51-53.
[9]	唐杰戚孟春胡静. 胶质细胞源性神经营养因子在自体静脉桥修复面神经缺损中促进神经再生的效应[J]. 华西口腔医学杂志, 2011, 29(01): 87-91.
[10]	徐欣,张学广,马跃,孙善珍. 聚四氟乙烯膜管内植入自体许旺氏细胞桥接面神经的实验研究[J]. 华西口腔医学杂志, 2005, 23(04): 316-318.
[11]	韩思源,王玉新,宋涛. 开放面神经管的神经移植在腮腺癌手术修复中的应用[J]. 华西口腔医学杂志, 2004, 22(03): 207-210.
[12]	王立军1,周树夏2,顾晓明1,张　英1. 氨基胍干预对创伤性面瘫大鼠外周面神经及周围组织一氧化氮合酶表达的影响[J]. 华西口腔医学杂志, 2004, 22(01): 7-9.
[13]	王彦亮,周树夏,雷德林,李兵仓,赖西南,张良潮. 面神经破冲复合伤模型的建立与研究[J]. 华西口腔医学杂志, 2003, 21(02): 95-97.
[14]	王琛,周树夏,郑春梅,邱建勇,宋俊峰. 家兔面神经撞击伤后胶质细胞源性的神经营养因子mRNA在面神经元中的表达特点[J]. 华西口腔医学杂志, 2002, 20(03): 178-180.
[15]	杨军,方泽强,李慧增,张从纪. bcl-2、Bax基因在面神经损伤后面神经元的表达及对神经元凋亡的调节[J]. 华西口腔医学杂志, 2001, 19(06): 360-362.

改良头皮冠状切口在颅颌面骨折手术中的应用

Application of modified coronal approach in treatment of craniomaxillofacial fractures

RichHTML

PDF (PC)

可视化

被引次数

摘要/Abstract

引用本文

使用本文

图/表 3

参考文献 12

相关文章 15

编辑推荐

Metrics

本文评价