CAJ | 학술논문

目的探讨睑缘切口联合耳颞切口进行颧骨复合体骨折复位内固定的临床应用效果.方法 53例颧骨复合体骨折患者,采用睑缘下切口联合耳颞切口进行骨折复位及坚固内固定,观察术后患者面部外形、开口度、咬合关系、神经损伤、视力、眼球运动以及手术瘢痕等变化.结果全部患者均Ⅰ期愈合,面部畸形明显改善;开口度、咬合关系恢复正常;复视及眼球运动障碍得到改善;眶下神经及面神经损伤的患者均有不同程度的恢复,并有部分患者完全恢复;没有出现因手术而导致的面神经颞支、眶上神经永久性损伤,术后部分患者面神经颞支有不同程度的暂时性损伤,1～3个月均完全恢复,无颞肌萎缩现象;无眼睑水肿、睑外翻、睑内翻出现;眼睑及耳颞部瘢痕隐蔽,不影响美观.结论睑缘切口联合耳颞切口进行颧骨复合体骨折的复位与坚固内固定,不但术野显露充分利于复位与内周定,而且手术后瘢痕隐蔽,不影响美观,也无明显手术并发症发生.
목적 탐토검연절구연합이섭절구진행권골복합체골절복위내고정적림상응용효과.방법 53례권골복합체골절환자,채용검연하절구연합이섭절구진행골절복위급견고내고정,관찰술후환자면부외형、개구도、교합관계、신경손상、시력、안구운동이급수술반흔등변화.결과 전부환자균Ⅰ기유합,면부기형명현개선;개구도、교합관계회복정상;복시급안구운동장애득도개선;광하신경급면신경손상적환자균유불동정도적회복,병유부분환자완전회복;몰유출현인수술이도치적면신경섭지、광상신경영구성손상,술후부분환자면신경섭지유불동정도적잠시성손상,1～3개월균완전회복,무섭기위축현상;무안검수종、검외번、검내번출현;안검급이섭부반흔은폐,불영향미관.결론 검연절구연합이섭절구진행권골복합체골절적복위여견고내고정,불단술야현로충분리우복위여내주정,이차수술후반흔은폐,불영향미관,야무명현수술병발증발생.
Objective To investigate the application of subciliary incision combined with preauricular temporal approach in the treatment of zygomatic complex fracture. Methods Fifty-three patients with zygomatic complex fracture including 41 males and 12 females were selected. Subciliary incision combined with preauricular temporal incision was employed to exp the site of fracture. After reduction of the fractures, rigid internal fixation was applied to fix the fractured bones. The facial profile, mouth opening, occlusion, view sight, movement of eye ball and local scar were evaluated postoperatively. Results The wounds of all the cases healed by first intension. All the cases had been recovered with normal face profile, mouth opening, occlusion, view-sight and eye ball movement. Facial nerve function of one case among the three cases with facial nerve trauma preoperatively was recovered totally after surgical treatment. And one case with suborbital nerve dysfunction preoperatively was not recovered. There was no case with the complications of entropion and ectropion, visible scar and temporal amyotrophia. Permanent trauma of temporal branch of facial nerve and supraorbital nerve was not observed after surgical therapy, but temporary facial nerve dysfunction occurred in 18 cases postoperative 1-3 months. Conclusion It is suggested that the approach of subciliary incision combined with preatrricular temporal incision could be employed to treat zygomatic complex fracture.