101例颌面部骨折患者临床回顾性研究

目的：总结分析颌面部骨折的临床特点和治疗方法。方法：总结101例颌面部骨折病例,从年龄、性别、季节特点、致伤原因、骨折类型、治疗方法、术后并发症等方面进行分析研究。结果：颌面部骨折多发于男性,好发年龄段20～50岁;夏季为好发季节,交通事故为主要致伤原因;下颌骨为骨折好发部位,常伴有全身多个脏器的复合伤;治疗以坚固内固定为主。结论：颌面部骨折以青壮年男性居多,主要为交通事故伤,正确复位后坚固内固定是最常用的治疗方法。     

钢板内固定在下颌骨骨折中的应用

由于交通事故及其他意外损伤事故的逐渐增多，下颌骨骨折病人比较常见。以往的治疗方法是采用颌间牵引固定，虽然通过这方法使多数病例咬牙合关系恢复较为满意，但仍有不足之处，即病人４～６周不能张口运动，既不利于口腔卫生，又影响病人的进食及营养补充。为了改进这一不足，我们根据骨科采用钢板内固定治疗长管骨骨折的原理应用于下颌骨骨折的固定。从１９８８年８月以来共收治下颌骨骨折病人３３例，均收到非常满意的效果。     

胸大肌肌皮瓣和全额皮瓣在颌面部缺损整复中的应用

1998年 3月～ 1 999年 1 1月 ,我科对 6例颌面部晚期肿瘤患者行大范围根治性肿瘤切除后 ,联合应用胸大肌肌皮瓣和全额皮瓣对颌面较大缺损进行整复 ,取得了满意的效果。现报告如下。1　资料与方法6例患者中 ,男 5例 ,女 1例 ;年龄 46～ 72岁 ,平均 63岁。其中腮腺癌 2例 ,颊部鳞癌 3例 ,下颌骨癌 1例。 6例腮部皮肤和颊部粘膜同时受到肿瘤的侵蚀。下颌骨癌累及部分口底组织。颈部患侧均有肿大淋巴结。气管切开插管全麻。按肿瘤根治的原则 ,切除面颊部、腮腺、咬肌、下颌骨及部分受累的口底组织 ,同时进行颈部淋巴结根治性切除。根据颊部、口…     

钛板坚固内固定术治疗面中部骨折的手术径路探讨

目的：总结分析坚固内固定术治疗面中部骨折的手术切口及暴露方法,探讨骨折复位及固定钛板的合理手术径路。方法：对76例手术病例进行总结,将骨折发生的部位及面部切口在每次手术中被使用的次数进行计数统计,分析各种手术径路的手术适应证及优缺点。术后随访半年以上,观察咬合功能恢复情况及面部美容效果。结果：上颌骨、颧骨骨折发病率较高,唇龈沟及下睑缘下隐蔽小切口的使用次数最多。半年后,面部切口愈合良好,无明显手术瘢痕形成,咬合功能恢复好。结论：合理选用手术切口能兼顾骨折部位暴露及面部美学效果。     

计算机辅助导航技术在鼻窦及鼻颅底手术中的应用

目的:探讨计算机辅助导航技术在鼻窦及鼻颅底手术中的应用价值。方法:49例患者(复发性鼻窦炎、鼻息肉25例,鼻腔鼻窦肿瘤9例,脑脊液鼻漏7例,脑膜脑膨出2例,先天性后鼻孔闭锁4例,垂体瘤1例,中颅窝底异物1例)均在计算机辅助导航下行鼻内镜手术。结果:计算机辅助导航术前准备时间为5～13min,平均7min,靶点误差≤1.5mm。49例患者均顺利完成手术,无并发症出现。结论:计算机辅助导航系统有助于术者正确判断鼻窦、颅底及相邻的解剖标志,可提高手术的精确性和安全性,减少术中及术后并发症的发生。     

CO_2激光在治疗口腔颌面部病损中的应用

CO_2激光在国外已被广泛应用于医学的各个领域,但在国内特别是在口腔颌面外科领域,仍处于起步和探索阶段。CO_2激光具有的精确的切割能力、对组织血运的气化封闭作用,是其应用于口腔颌面外科手术的重要优势。本文拟结合笔者经验、国内外文献资料,探讨CO_2激光在治疗口腔颌面部病损的应用。     

鼻内窥镜技术在面中部骨折治疗中的应用

报告8例面中部骨折病人，其中鼻额筛复合骨折6例，击出性骨折（眶底暴折）2例。治疗中结合鼻内窥镜技术，获得了术前诊断明确，术中操作细致、准确，术后恢复迅速，8例均治愈出院，随访半年～1年疗效满意。     

3D打印技术在鼻-颅底外科中的应用研究进展

3D打印技术近年来在生物医学领域的应用较为广泛,虽然在鼻-颅底外科领域中的应用研究鲜有报道,但凭借其快速成型、立体化三维实物重现等优势,在鼻-颅底外科领域有着广阔的应用前景。其临床应用主要涉及鼻-颅底缺损修复、术前规划及术前手术模拟、解剖教学及培训、患者教育等方面。本文围绕3D打印技术在鼻-颅底外科领域的应用现状作一概述,同时对其发展前景进行展望。     

采用唇龈切口在内镜辅助下行颧上颌复合体骨折复位内固定的临床应用

随着现代医学的发展,内镜在临床上的使用越来越广泛。颧上颌复合体（zygomaticomaxillary complex,ZMC）骨折在临床上常见,治疗上除考虑到复位的效果,也应考虑到美容的效果。2005年以来,我科诊治颧骨骨折22例,应用内镜下经口及上颌窦内行ZMC骨折复位内固定9例,取得较好的治疗效果,现报告如下。     

半冠状切口结合小钛板固定治疗颧骨复合体骨折

目的 观察半冠状切口结合小钛板固定治疗颧骨复合体骨折的疗效。方法 25例颧骨复合体骨折患者，其治疗方案均采用半冠状切口下完成骨折复位，继以小钛板内固定，术后随访3～12月，观察治疗效果。结果所有病例术后创口均Ⅰ期愈合，无术后并发症发生，面部外形及功能恢复满意。结论 半冠状切口结合小钛板固定治疗颧骨复合体骨折具有切口隐蔽、安全、固定可靠及可以早期进行功能锻炼等优点，疗效满意，值得临床推广。     

Robotic surgical systems in maxillofacial surgery:a review

Throughout the twenty-first century, robotic surgery has been used in multiple oral surgical procedures for the treatment of head and neck tumors and non-malignant diseases. With the assistance of robotic surgical systems, maxillofacial surgery is performed with less blood loss, fewer complications, shorter hospitalization and better cosmetic results than standard open surgery. However, the application of robotic surgery techniques to the treatment of head and neck diseases remains in an experimental stage, and the long-lasting effects on surgical morbidity, oncologic control and quality of life are yet to be established. More well-designed studies are needed before this approach can be recommended as a standard treatment paradigm. Nonetheless, robotic surgical systems will inevitably be extended to maxillofacial surgery. This article reviews the current clinical applications of robotic surgery in the head and neck region and highlights the benefits and limitations of current robotic surgical systems.     

Impact of COVID-19 on maxillofacial surgery practice: a systematic review

ObjectivesThe aim of this systematic review was to evaluate the possible impacts of COVID-19 on oral and maxillofacial surgery practice, as well as the protocols employed by oral and maxillofacial surgeons to minimize the risks of contamination.MethodsSearches were performed in different databases up to 15 March 2021. Articles related to oral surgery dynamics within the context of the COVID-19 pandemic were included. The articles were considered eligible if they met the following inclusion criteria: observational studies that provided recommendations regarding maxillofacial surgery measures during the COVID-19 pandemic and that analyzed the risk of contamination of patients/professionals with SARS-CoV-2.ResultsSeven studies met the inclusion criteria and were selected for the present systematic review. Demands for personal protective equipment increased significantly, with studies reporting the scarcity of fundamental equipment such as FFP2/N95 masks. Significant changes in the infrastructure of outpatient, surgical and inpatient units and in the care protocols themselves were observed.ConclusionThe COVID-19 pandemic particularly affected the routine of oral and maxillofacial surgery residents. Several additional recommendations for surgical practice or for the surgical team were evaluated and discussed, such as performing primarily urgent and emergency surgeries, remote patient care and screening, postponing elective surgeries, and new teaching methods in oral and maxillofacial surgery residency programs. In addition, screening of patients and of the surgery team for COVID-19 is strongly recommended.     

早期确定性手术治疗严重鼻眶筛区骨折

目的：探讨早期确定性手术治疗鼻眶筛区（naso-orbital-ethmoid, NOE）骨折的疗效。方法:对23例严重鼻眶筛区骨折急诊患者,根据全身状况、骨折部位、畸形特征确定手术顺序、术式组合,行鼻眶筛区骨折复位、微型钛板坚固内固定、内眦韧带悬吊等,恢复面部支架、外形及功能。结果:23例患者面型、张口度及咬颌关系均恢复或基本恢复正常,内眦间距变小,内眦水平鼻梁矢状高度增大,3例眼球陷没改善,复视消失。结论:对严重鼻眶筛区骨折患者应尽早施行确定性手术。     

经结膜切口在眶底和眶下缘骨折中的应用

目的 :探讨眶底和眶下缘骨折的手术进路。方法 :对 15例眶底和眶下缘骨折采用经结膜切口进行治疗。结果 :所有病例都在经结膜切口下完成眶底和眶下缘骨折的复位和固定 ,术后伤口均一期愈合 ,无睑外翻、泪道损伤等并发症发生。结论 :经结膜切口是治疗眶底和眶下缘骨折的一种较为理想的手术进路 ,能提供足够的暴露并避免面部瘢痕形成。     

Role of fixation in the treatment of nasal fractures

Following the reduction of nasal fractures, fixation was performed in 3 ways: 1 Packing for 72 h and plaster cast for 1 week. 2 Packing for 72 h and adhesive tape for 1 week. 3 Adhesive tape for 1 week. At follow-up 3 months after the reduction, these groups were compared with a group of patients with nasal fractures which had not needed treatment and with a group of normals. It was concluded that among the group fixed with packing and plaster cast, significantly fewer patients were dissatisfied than in the other groups, and fewer complained of deformity. The physical examination showed an appreciable number of minor deformities in all groups including the normal group. A significantly higher frequency of nasal obstruction was found in the group of patients operated upon compared to the non-operated group and the normal group by physical examination, but not by the questionnaire. The present study does not support the point of view that a high percentage of cases of nasal fracture have to be operated upon by open reduction. Radiology has no medical or legal value in patients with nasal fractures and should not be used.     

Use of rigid internal fixation in the repair of complex and comminuted mandible fractures

An overview of the use of rigid internal fixation using the AO method for the repair of complex mandibular injuries is presented. The end result of such an approach is the return of the patient as rapidly as possible to his or her normal status with return to normal alimentation, normal mobility of the mandible, normal airway, and normal access to the oral cavity.