经耳前腮腺小切口径路治疗髁突中位骨折

目的：探讨经耳前腮腺径路治疗髁突中位骨折的方法。方法：回顾性分析经耳前腮腺径路治疗髁突中位骨折26例35侧的临床资料，记录术前、术后的腮腺涎漏、张口受限程度、面神经损伤及咬合紊乱等情况，通过术前、术后曲面断层片评估骨折复位与愈合状况。结果：全部病例手术过程顺利。手术时间平均（1．5±0．3）h；伤口一期愈合；全部病例均获得良好的咬合关系；3例出现涎瘘，经加压包扎后治愈；张口度恢复至3．5 cm。术后1～3个月复查曲面断层片显示骨折复位及愈合良好；4例出现暂时性面瘫，术后3～6个月复查面瘫症状消失。结论：经耳前腮腺小切口径路治疗髁突中位骨折可获得满意效果。

Premenstrual ears parotid incision approach in the treatment of mandibular condylar fractures

Objective:To evaluate the effects of pre-auricular parotid gland approach in the treatment of mandibular condylar neck fracture. Method:Clinical data of patients with mandibular condylar neck fracture (26 patients,35 temporo-mandibular joints) were collected and analyzed retrospectively. The clinical information of pre-and post-operative parotid salivary fistula,limited mouth opening,facial nerve injury and malocclusion was recorded respectively. Meanwhile,pre- and post-operative panoramic images were used to evaluate the reductive and healing state of the fractures. Result:All the op-erations were uneventful, with an average operation time 1.5 hours,(mean ±SD,1.5 ±0.3). The wound healed well and a good occlusion was achieved in all the patients. Parotid salivary fistula occurred in 3 patients after operation , but disap-peared after pressure dressing. A mouth opening over 3.5cm was achieved in all the patients. The post-operative panoramic images (1~3 months later) showed the fracture reduction and healing was good. Facial paralysis occurred in four patients after operation, but disappeared 3~6 months later. Conclusion:The effects of pre-auricular parotid gland approach in the treatment of mandibular condylar neck fracture are satisfactory.