口腔颌面锥形束CT在髁突骨折诊断及治疗中的应用

目的：探讨口腔颌面锥形束CT（CBCT）在髁突骨折诊断及治疗中的应用。方法：回顾分析西安交通大学口腔医院口腔颌面外科自201O年1月～2012年6月诊治的髁突骨折42例（59侧），每例患者术前均行CBCT检查。其中有28例（32侧）在CBCT检查之前已行曲面断层全景片检查，17例（25侧）已行螺旋cT检查。结果：2侧骨折经曲面断层颌全景片检查后漏诊，漏诊率6．25％；螺旋cT和CBCT检查无误诊和漏诊，均可以确诊髁突骨折，并明确骨折部位及分型。42例（59侧）髁突骨折中，髁头（囊内）骨折13侧，髁颈骨折27侧，髁突下骨折19侧。13侧囊内骨折中，A型7侧，B型4侧，C型0例，M型2侧。PDA分类，Ⅰ型28侧，Ⅱ型11侧，Ⅲ型20例。结论：对于髁突骨折的诊断，CBCT是一种简单可靠的影像学技术，并可以明确骨折类型，对其治疗具有重要的指导意义。

The application of the Cone Beam Computed Tomography in the diagnosis and treatment of condylar fractures

Objective To study the application of the Cone Beam Computed Tomography （CBCT） in the diagnosis and treatment of condylar fractures. Methods Retrospective analysis of 42 cases with 59 sides condylar fracture in xi ＇an jiaotong university stomatological hospital from January 2010 to June 2012. Each patient went through a preoperative examination of CBCT, in which 28 cases with 32 sides have made a panoramic examination and 17 cases with 25 sides have made a Spiral Computed Tomography examination before examination of CBCT. Results Two sides of condylar fractures were missed diagnosis after panoramic examination （6.25%）.No patient was misdiagnosed and missed diagnosis through Spiral CT and CBCT examination.They both can identify condylar fracture and classification. Of overall 59 sides condylar fractures, 13 sides belong to intracapsular fracture, 27 sides belong to neck fracture, and 19 sides belong to subcondylar fracture.Of overall 13 sides of intracapsular fracture,7 sides belong to type A,4 sides belong to type B, 2 sides belong to type M.According to the classification of PDA,28 sedes belong to type Ⅰ ,11 sides belong to type Ⅱ, 20 sides belong to type Ⅲ. Conclusion For diagnosis of condylar fractures,CBCT is a simple and reliable imaging technology. It can identify the fracture types and of great importance in the treatment of fractures,