颧上颌骨复合体骨折内固定58例临床总结

doi:10.3969/j.issn.1005-4979.2017.06.005

摘要/Abstract

摘要： 目的：总结经上颌前庭沟入路进行眶下缘固定同时联合眉弓外侧、耳颞切口入路治疗颧上颌骨复合体骨折的临床经验。方法：回顾性分析2014-01—2016-01期间福建医科大学附属第一医院口腔颌面外科经CT检查确诊为颧上颌复合体骨折的病例资料，共58例。分析临床表现、手术入路、预后及随访6个月的愈合情况。结果：本组中所有病例经过上颌前庭沟、眉弓外侧切口、耳颞切口联合入路进行手术治疗后，均获得满意的治疗效果。随访6个月，2例出现伤口感染，换药后痊愈；3例出现面神经颞支暂时性损伤，术后3个月左右全部恢复正常。所有患者面部外形对称，无张口受限。结论：经上颌前庭沟切口进行眶下缘内固定并联合眉弓外侧、耳颞切口治疗颧上颌复合体骨折的方法是治疗此类疾病的良好方法，在达到良好治疗效果的同时，又可避免睑缘下切口导致的睑外翻和瘢痕等并发症，值得在临床上推广。

关键词: , , 颧上颌骨复合体骨折； , , 上颌前庭沟切口； , , 小切口； , , 微小侵袭外科

Abstract: Objective: To summarize the clinical experience of buccal maxillary vestibular groove incision for fixation of the infraorbital rim and combined with ear-temporal incision and eyebrow incision for the treatment of zygomatic maxillary complex(ZMC) fractures. Methods: The clinical data of 58 patients with ZMC fractures during January 2014 and January 2016 were analyzed retrospectively. All cases were confirmed by CT examination. Here we summarized the experiences of clinical manifestations, surgical approaches, prognosis and recovery status (6 months after operation). Results: All patients in this group had satisfactory outcomes after surgical treatment via buccal maxillary vestibular groove incision combined with ear-temporal incision and eyebrow incision. During the followed up of 6 months, only two cases had their wound infected after surgery, but recovered after dressing. Temporal branch of facial nerve temporary paralysis were damaged in three cases, but all restored at three months after surgery. All patients' faces were symmetrical without trismus. Conclusion: The method of buccal maxillary vestibular groove incision for fixation of the infraorbital rim and combined with ear-temporal incision and eyebrow incision is a good way to treat ZMC fractures. It can not only achieve good therapeutic outcome but also avoids ectropion of eyelids and scar and other complications caused by subciliary incision, which could be recommended for clinical use.

Key words: zygomatic maxillary complex fracture, buccal maxillary vestibular groove incision, minimal incision, minimally invasive surgery

中图分类号:

R782.4

朱小峰1，廖云阳1，黄跃 1，施斌1，林李嵩1,张斌2. 颧上颌骨复合体骨折内固定58例临床总结[J]. 《口腔颌面外科杂志》, doi: 10.3969/j.issn.1005-4979.2017.06.005.

ZHU Xiao-Feng1, LIAO Yun-Yang1, HUANG Yue1, SHI-Bin1, LIN Li-Song1, ZHANG Bin2. Internal Fixation for the Treatment of Zygomatic Maxillary Complex Fractures[J]. 《Journal of Oral and Maxillofacial Surgery》, doi: 10.3969/j.issn.1005-4979.2017.06.005.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2017/V27/I6/401

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