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目的:探讨颞下颌关节(temporomandibular joint,TMJ)盘锚固术中游离脂肪瓣的影像学变化及组织学转归。方法:选取3个月龄小型猪6只,术前拍摄TMJ MRI,将左侧作为实验组,对其进行关节盘前附着松解,并切取耳前区脂肪瓣,移植到TMJ松解后的间隙内。右侧作为对照组,只进行关节盘前附着松解。术后即刻、3、6个月分别拍摄TMJ MRI,观察脂肪组织的影像学变化。术后3、6个月各处死动物3只,取脂肪标本,测量脂肪组织的体积,并进行HE染色,观察其组织学变化。结果:MRI示移植的脂肪组织在术后3个月、6个月信号逐渐减弱,脂肪瓣体积在术后3个月减少到67.7%,术后6个月减少为42.6%。HE染色示术后3个月脂肪组织呈现慢性炎症反应,术后6个月可见新的脂肪小叶形成,小叶间纤维组织增生明显。结论:游离脂肪瓣移植6个月后,脂肪瓣部分存活,体积稳定,为TMJ外科临床应用游离脂肪瓣提供了理论支持。
Objective: To investigate the imaging changes and histological findings of free fat flap in temporomandibular joint (TMJ) disk anchoring. Methods: Six miniature 3-month-old pigs were selected. TMJ MRI was performed preoperatively and the left side was used as the experimental group. The anterior plateau was dissected and the anterior ear fat flap was excised and transplanted into TMJ Within the gap. The right side as a control group, only the pre-disc attachment and release. Immediately after surgery, 3 and 6 months respectively, TMJ MRI was performed to observe the imaging changes of adipose tissue. At 3 and 6 months after operation, 3 animals were sacrificed. The fat samples were taken and the volume of adipose tissue was measured. HE staining was performed to observe the histological changes. Results: MRI showed that the transplanted adipose tissue signal gradually weakened at 3 months and 6 months after operation. The volume of fat flap reduced to 67.7% at 3 months and 42.6% at 6 months after operation. Hematoxylin and eosin staining showed that chronic inflammation was observed in adipose tissue 3 months after operation. New adipose tissue was seen at 6 months after operation, and fibrosis of interlobular fibrosis was obvious. CONCLUSION: After 6 months of free fat flap transplantation, the part of fat flap survives and the volume is stable, which provides theoretical support for the clinical application of free fat flap in TMJ surgery.