异体肋软骨移植治疗颞下颌关节强直的临床研究

目的:评价应用异体肋软骨移植治疗真性颞下颌关节(TMJ)强直的效果。方法:选择6例颞下颌关节强直患者,经耳前进路,凿除关节区增生、融合的骨质,保持凿开间隙1.0cm。形成的假关节间隙内植入雕刻成型的、经液氮保存的同种异体肋软骨。结果:所有患者术后均未见排异反应发生,随访3年均无关节强直复发,开口度3.0～4.5cm,开口型无明显偏斜,面部外形无明显畸形。结论:同种异体肋软骨移植可以用于TMJ真性强直的治疗,其术后重建的颞下颌关节的功能和患侧面部形态令人满意,但其远期效果有待进一步研究。

A preliminary study of the treatment of temporomandibular joint ankylosis using allograft of rib cartilage

PURPOSE: To investigate the treatment of temporomandibular joint ankylosis in clinic using homologous rib cartilage grafts. METHODS: 6 cases of TMJ ankylosis was treated using homologous rib cartilage. The hyperplasic and malformed bone in the ankylosis area was resected with grafts a space in 1cm left. The preserved and shaped frozen rib cartilage was grafted into the prefabricated space. RESULTS: The transplanted homologous rib cartilage grafts had no significant immune rejection and successfully prevented the adhesion of the bone after 3 years. With approximate normal occlusion, the postoperative mouth opening was 3.0 to 4.5cm. CONCLUSION: With excellent shape and structure, the homologous rib cartilage graft was suitable for treatment of ankylosis of which TMJ successfully prevented the adhesion of the bone as well as biological rebuilding of the TMJ.