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目的探讨应用耳周小切口穿腮腺径路行髁突颈部及基底部等中低位骨折手术的治疗方法及临床疗效。方法对30例38侧下颌骨髁突中低位骨折患者采用耳屏前或内,或绕耳垂小切口,穿经腮腺组织后行骨折段的解剖复位及坚固内固定,术后随访6个月到3年,从患者的外形、张口度、咬合功能、并发症及影像学检查等方面进行疗效分析。结果30例患者中,1例出现一侧暂时性面神经功能不全,1例出现涎瘘,其他患者均外形满意,咬合关系良好,未发生明显并发症。张口度最大者4.2cm,最小者3.3cm,术后CT示所有患者骨折段均完全解剖复位。结论较之传统的手术径路,应用耳周小切口经腮腺径路治疗髁突中低位骨折具有切口小,操作简便,并发症少,能达到直视下进行手术的目的。
Objective To investigate the treatment and clinical effect of mid-and-low-angle fractures of the condylar neck and the basal part treated with parotid gland approach with a small peri-ear incision. Methods Thirty patients with low or middle mandibular condyle fractures were treated with anterior or posterior tragus or a small incision around the ear lobes. The anatomical reduction and internal fixation of the fracture were performed through the parotid gland. The patients were followed up for 6 months Three years, from the patient’s appearance, mouth opening, occlusal function, complications and imaging studies and other aspects of efficacy analysis. Results Of the 30 patients, one had transient facial nerve insufficiency on one side, one had salivary fistula, while the other patients were satisfied with satisfactory occlusion. There was no obvious complication. The largest mouth 4.2cm, the smallest 3.3cm, postoperative CT showed all patients with fracture segments were completely anatomical reduction. Conclusion Compared with the traditional surgical approach, the application of small ear ear incision through the parotid pathology in the treatment of low and middle condylar fractures with small incision, easy to operate, fewer complications, to achieve the purpose of surgery under direct vision.