本文選題：髁頸下骨折 + 面神經(jīng)解剖�。� 參考：《口腔頜面外科雜志》2015年06期

【摘要】：目的:在用改良切口行下頜骨髁頸下骨折切開復(fù)位堅(jiān)固內(nèi)固定手術(shù)時(shí),比較順行和逆行2種方法解剖面神經(jīng)的效果。方法:2010-06—2014-12期間收治了36例患者(均為單側(cè)髁頸下骨折),均在三明市第一醫(yī)院口腔頜面外科,采用改良切口行下頜骨髁頸下骨折切開復(fù)位堅(jiān)固內(nèi)固定術(shù)。其中有11例使用順行面神經(jīng)解剖方法(順行組),有25例使用逆行面神經(jīng)解剖方法 (逆行組),對比兩組的雙鈦板固定情況和術(shù)后的面神經(jīng)的損傷、涎漏方面的數(shù)據(jù)。結(jié)果:兩組在雙鈦板固定方面有顯著差異(P=0.023)。在順行組中,有8例為雙鈦板固定,3例只固定1塊鈦板;在逆行組中,25例全部為雙鈦板固定。兩組在面神經(jīng)損傷方面差異有統(tǒng)計(jì)學(xué)意義(P=0.020),在順行組中暫時(shí)性面癱7例,而在逆行組中暫時(shí)性面癱有5例,兩組均無永久性面癱。在術(shù)后涎漏方面差異有統(tǒng)計(jì)學(xué)意義(P=0.023),順行組術(shù)后發(fā)生涎漏4例,而在逆行組發(fā)生涎漏的只有1例。結(jié)論:用改良切口行下頜骨髁頸下骨折切開復(fù)位堅(jiān)固內(nèi)固定手術(shù)時(shí),逆行性面神經(jīng)解剖法更好。
[Abstract]:Objective: to compare the effect of anterograde and retrograde dissection of facial nerve during open reduction and rigid internal fixation of mandibular condylar and cervical fractures with modified incision. Methods Thirty-six patients (all unilateral subcondylar and subcondylar fractures) were treated by the modified incision in oral and maxillofacial surgery of Sanming first Hospital in the period of 2010-06-2014-12. Open reduction and rigid internal fixation of subcondylar and cervical fractures of the mandible were performed by modified incision. Among them, 11 cases were dissected by antegrade facial nerve method (anterograde group) and 25 cases by retrograde facial nerve dissection (retrograde group). The data of bilateral titanium plate fixation, facial nerve injury and salivary leakage were compared between the two groups. Results: there was significant difference between the two groups in double titanium plate fixation. In the anterograde group, there were 8 cases with double titanium plate fixation, 3 cases with only one titanium plate, and 25 cases with retrograde group with double titanium plate fixation. The difference between the two groups in facial nerve injury was statistically significant. In the anterograde group, 7 cases were temporary facial paralysis, while in retrograde group there were 5 cases of temporary facial paralysis. There was no permanent facial paralysis in both groups. The difference in postoperative salivary leakage was statistically significant (P < 0.023). In the anterograde group, there were 4 cases of coveal leakage, but only 1 case in the retrograde group. Conclusion: the retrograde facial nerve anatomic method is better in the open reduction and rigid internal fixation of mandibular condylar and cervical fractures with modified incision.
【作者單位】： 福建醫(yī)科大學(xué)附屬三明市第一醫(yī)院口腔頜面外科;
【分類號】：R782.4;R322
，

本文編號：1815171