摘要： 目的：探讨经腮腺边缘穿咬肌入路行髁突骨折坚固内固定的临床效果。方法：回顾分析2014-05—2017-01收治的30例36侧髁突骨折患者的诊治经验。其中21侧髁突中低位骨折，通过颌后切口经腮腺前缘穿咬肌入路行坚固内固定术。15侧髁突高位骨折通过改良耳屏切口，经腮腺前、上缘穿咬肌入路行坚固内固定术，术后随访6个月，从患者的咬合关系、开口度、涎瘘及面神经功能等方面进行评估。结果：30例患者术后咬合关系和开口度均恢复良好，无涎瘘的病例出现，有4例出现暂时性面瘫，2月后内恢复。结论：经腮腺边缘穿咬肌入路手术治疗髁突骨折，视野暴露充分，切口隐蔽，利于保护面神经，并发症少，是安全有效的手术入路之一。

关键词: 腮腺, 髁突骨折, 坚固内固定

Abstract: Objective: To investigate the clinical effect of transmasseteric marginal parotid approach and rigid internal fixation in the treatment of mandibular condylar fractures． Methods: From May 2014 to January 2017, 36 mandibular condylar fractures of 30 patients were retrospectively reviewed． 21 cases with mid-and-low mandibular condylar fractures were treated by posterior mandibular transmasseteric anterior parotid approach．15 cases with higher mandibular condylar fractures were treated by improved tragus transmasseteric anterior-superior parotid approach． After postoperative follow-ups for 6 months, The occlusal relationship, jaw opening, facial nerve function, salivary fistula and other clinical indicators were evaluated． Results: All the patients restored to normal occlusion relationship and normal degree of jaw opening． There were no salivary fistula． Temporary facial paralysis occurred in 4 cases and recovered after 2 months． Conclusion: Transmasseteric marginal parotid approach for treatment of mandibular condylar fractures can provide adequate exposure and the hidden incision, protect the facial nerve, and reduce complications． It is one of the security effective operative access．

Key words: parotid gland, mandibular condylar fractures, rigid internal fixation

中图分类号: 

• R782.4