CAJ | 학술논문

目的探讨内镜辅助肋骨-软骨移植重建髁突与同期正颌手术治疗严重颞下颌关节病变及牙颌面畸形的效果. 方法于术前对患者进行临床检查和治疗设计,术中行Le Fort Ⅰ型截骨术、下颌支矢状骨劈开术、髁突等关节区病变的处理、内镜辅助下肋骨-软骨移植和颏成形术,术后进行随访. 结果 2003年9月至2005年12月,于临床应用15例,所有患者同期手术均顺利完成.术中、术后均无严重出血、神经损伤、受区感染等严重并发症发生.术后随访29～52个月,平均31.8个月,所有患者面容均显著改善,关节功能良好,且无关节区疼痛等主观症状,患者对手术疗效满意.术后张口度平均为33.6 mm,侧向运动度为0～6 mm. 结论选择合适的适应证、设计合理的手术方案,内镜辅助髁突重建同期正颌手术效果较好.
목적 탐토내경보조륵골-연골이식중건과돌여동기정합수술치료엄중섭하합관절병변급아합면기형적효과. 방법 우술전대환자진행림상검사화치료설계,술중행Le Fort Ⅰ형절골술、하합지시상골벽개술、과돌등관절구병변적처리、내경보조하륵골-연골이식화해성형술,술후진행수방. 결과 2003년9월지2005년12월,우림상응용15례,소유환자동기수술균순리완성.술중、술후균무엄중출혈、신경손상、수구감염등엄중병발증발생.술후수방29～52개월,평균31.8개월,소유환자면용균현저개선,관절공능량호,차무관절구동통등주관증상,환자대수술료효만의.술후장구도평균위33.6 mm,측향운동도위0～6 mm. 결론 선택합괄적괄응증、설계합리적수술방안,내경보조과돌중건동기정합수술효과교호.
Objective To investigate one-staged orthognathic surgery and arthoscope-assisted condylar reconstruction with costochondral graft for temporomandibular diseases combined with dental-maxillofacial deformities. Methods The preoperative measurement and model surgery was performed. The patients underwent arthoscope-assisted condylar reconstruction with costochondral graft combined with bimaxillary surgery or mandibular surgery. Results From Sept. 2003 to Dec. 2005, 15 cases were treated successfully with no bleeding, nerve injury and infection. The patients were followed up for 29 to 52 months(mean,31.8 months). The appearance was markedly improved. TMJ function was good with no pain. The average maximum interincisal opening was 33.6mm. Conclusion Compared with traditional operation, one-staged orthognathic surgery and arthoscope-assisted condylar reconstruction with costochondral graft has its advantages. Indication selection and preoperative design are very important.