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目的:探讨穿腮腺入路治疗髁突基部斜形骨折的手术方法及其疗效。方法:对18例(21侧)髁突基部斜形骨折患者采用腮腺区“S”形切口,穿腮腺入路进行切开复位和内固定术。结果:5例患者前牙开牙合,经颌间牵引2周咬合关系明显改善;8例张口受限,经张口训练术后3个月均恢复正常;3例张口偏斜,术后6个月恢复正常;4例4侧出现面神经损伤症状,其中1例颧支损伤术后1个月恢复正常,3例颊支损伤术后3个月恢复正常。患者均未出现涎瘘,骨折断端对位良好,钛板钛钉固定良好,未见髁突吸收及关节强直现象。结论:采用腮腺区“S”行切口,穿腮腺入路进行切开复位和内固定术是治疗髁突基部斜形骨折的较好方法。
Objective: To investigate the surgical treatment of oblique condylar fracture at the base of parotid gland and its curative effect. Methods: Eighteen patients (21 sides) with condylar base oblique fractures were treated with parotid gland suture incision and internal fixation through parotid approach. Results: The occlusal relationship of the anterior teeth of the 5 patients with open anterior teeth was significantly improved 2 weeks after intermaxillary traction. In 8 patients, the mouth was restricted and returned to normal after 3 months of mouth opening operation. Months returned to normal; facial nerve injury occurred in 4 cases 4 cases, 1 case of zygomatic branch injury returned to normal one month after surgery, 3 cases of buccal branch injury 3 months after the return to normal. No salivary fistula occurred in all patients. The fractures were well aligned and the titanium plate was well fixed. There was no condyle absorption and ankylosis. Conclusion: It is a good way to treat the oblique fracture of the condylar base with the parotid gland sutural incision and the parotid gland approach for open reduction and internal fixation.