髁突骨折手术复位固定的临床评价

髁突颈部是下颌骨骨结构中最薄弱的部位,髁突骨折大多发生于此,其发生率约占颌面部骨折的20～50%[1].当髁突遭受不同方向和力量的暴力打击以及受翼外肌牵拉的影响,常造成不同类型的髁突骨折移位或脱位,并产生局部疼痛,错合畸形及下颌运动障碍等症状.本院髁突骨折占颌面部骨折的21%.以往对于髁突骨折是否采用手术治疗争议颇多[2].现将我科手术治疗的11例髁突骨折病例作一回顾性分析,以探讨其手术疗效.     

肉毒杆菌毒素在下颌骨颏突骨折闭合性治疗中的应用

下颌骨骨折是颌面部最常见的骨折,其中有25％-30％伴有髁突骨折。与儿童髁突骨折非手术治疗的一致性见解相比,成人髁突骨折的治疗仍存在较大争议。虽然很多文献对有关髁突骨折开放性治疗的完全性或相对适应证进行了研究,但仍没有最终证明开放性治疗较保守治疗具有优越性。目前髁突骨折的治疗大部分是基于传统治疗方法和经验。本研究旨在讨论咀嚼肌内注射肉毒杆菌毒素A保守治疗下颌骨髁突骨折的临床效果,以探讨下颌骨髁突骨折的最佳治疗方法。     

口腔颌面部创伤

颌间牵引钛钉在颌骨骨折整复中的应用；翼外肌一髁突解剖复位内固定治疗髁突骨折的探讨；颌面部交通事故伤237例临床分析；发际内头皮冠状切口在颧骨颧弓骨折治疗中的应用；眶底骨折钛网修复13例临床分析；颧眶骨折合并眼球内陷的治疗。     

髁状突骨折开放性和闭合性治疗的比较

下颌骨骨折是颌面部最常见的骨折,其中25％～35％有髁状突骨折。长期以来,对髁状突骨折的处理在临床上有较大争议。一般认为,对儿童髁状突骨折患者应以保守治疗为主,对成人则根据情况选择保守或手术治疗。本文作者选择部分诊断相同的髁状突骨折病例,分别采用保守治疗和手术治疗,并进行长时间随访,比较二者的预后,为临床上选择治疗方案提供参考。     

口腔颌面部创伤

实验性骨质疏松症对下颌骨骨折愈合的影响；颧骨复合体骨折临床治疗探讨；526例下颌骨髁状突骨折临床病例回顾性研究；上颌骨骨折合并泪道损伤的早期处理及意义；重症颌面部损伤患者的首（急）诊护理；下颌骨髁突骨折治疗的Meta分析；颌面创伤3958例临床回顾；69例老年患者颌面部骨折的临床分析；颌骨骨折合并颅脑损伤的处理；颌面部外伤患者早期的个性及心理调查。[编者按]     

口腔颌面部创伤

20062385网状眶底修复钛板治疗眶底骨折；20062386坚强内固定在下颌骨髁突骨折治疗中的应用；20062387儿童口腔颌面部损伤487例临床分析；20062388呼吸道监护在颌面创伤救治中的作用探讨；20062389眶壁颌面部复合性骨折的早期手术治疗。[编者按]     

髁突骨折不同治疗方法的疗效

髁突骨折是下颌骨骨折的好发部位之一,约占下颌骨骨折的25%～52%,儿童可高达40%～67%[1,2]。髁突骨折是口腔颌面部损伤中较难解决的问题之一,作者对收治的42例髁突骨折分别采用保守治疗和微型钛板内固定治疗,现总结报告如下:1临床资料和方法1.1一般资料男29例,女13例;年龄8～50     

口腔颌面外科学——麻醉与手术

局麻药中肾上腺素对高血压拔牙患者血压和脉搏的影响，下颌下径路经口气管内插管在颌面部骨折治疗中的应用，髁突多发性骨折微型钛板内固定的近期观察，介入治疗在下颌骨动静脉畸形的临床应用，儿童上颌前牙区埋伏多生牙的临床分型与治疗，口腔内入路行髁突高位骨折复位固定的临床治疗。[编者按]     

口腔颌面部创伤

螺旋CT三维重建在髁突骨折中的临床运用；武警部队官兵颌面部骨折临床病例回顾性研究；钛网在颌骨粉碎性骨折复位中的应用；儿童颌面部骨折治疗的临床研究；颌面部创伤不同缝合法的心理学差异（附80例报告）；颌面部损伤患者265例的临床护理体会；颧上颌骨骨折42例临床分析；……[编者按]     

儿童下颌骨髁突骨折的治疗进展

儿童髁突骨折是常见的骨折类型之一,占下颌骨骨折的40％～67％.对儿童髁突骨折治疗方法的选择一直存在着争议,仍无统一观点.治疗方法一般分为闭合性治疗和开放性复位.由于儿童髁突骨折的特点,其治疗结果会影响下颌骨和颌面部的发育.此外,治疗导致的并发症如颞下颌关节紊乱或强直等也是目前争论的焦点.本文通过回顾与结合相关文献,就儿童的定义、儿童髁突骨折的特点、分类及治疗进展等相关内容作一综述,以期对临床实践提供参考和帮助.     

Unusual Superolateral Dislocation of Bilateral Mandibular Condyles

We describe a case of maxillofacial trauma in a paediatric patient in which the left mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact and the right condyle was also displaced similarly but the zygomatic arch was also fractured on this side. Also, there was an associated mandibular symphyseal fracture.     

颌面部骨折472例临床分析

本文通过对我科自１９７６年以来诊治的４７２例颌面部骨折病例的临床总结和分析，结合对近年来文献资料的复习，对颌面部骨折的诊断，治疗时机以及各种类型的骨折复位固定方法进行了全面论述，认为微型夹板坚固内固定技术是颌面部骨折较理想的固定方法。     

Pseudoaneurysm of the external carotid artery secondary to subcondylar fracture

Arterial pseudoaneurysms are rare in oral and maxillofacial surgery, but when they occur, quick recognition and management is necessary to avoid devastating consequences. The authors report a case of a pseudoaneurysm of the external carotid artery that developed after open reduction and internal fixation of a mandibular condyle fracture.     

Does a "hub and spoke" maxillofacial trauma service affect management decisions?

AIM: Using mandibular fractures (excluding those of the condyle) as a model, to find out how management is influenced by whether patients present at the "hub" or "spoke" of a maxillofacial trauma service. MATERIALS: Data on non-condylar mandibular fractures from a maxillofacial trauma database over a 5-year period. RESULTS: Significantly more non-condylar mandibular fractures were treated conservatively in patients who presented at the peripheral spoke hospitals than in those who presented at the hub hospital, despite the populations being similar. CONCLUSION: Geographical presentation of a patient with a non-condylar mandibular fracture in a hub and spoke maxillofacial trauma service influences management decisions.     

克氏针治疗下颌骨髁突矢状骨折13例回顾性分析

目的探讨克氏针内固定方式在下颌髁突矢状骨折治疗中的应用价值。方法回顾分析2019年1月至2020年1月在广州中医药大学附属佛山市中医院口腔医疗中心就诊的下颌骨髁突矢状骨折复位后采用克氏针内固定治疗的患者,共13例19侧。治疗过程包括常规手术切开、暴露并复位游离的下颌骨髁突后,根据下颌骨髁突骨质断端情况利用2~4根克氏针固定,伴发其他部位骨折时同期手术治疗。术后1周通过CBCT评估游离的下颌骨髁突复位精准度及稳固性,通过临床检查评价咬合关系、开口度、开口型。结果所有患者骨折断端对位良好,克氏针无扭曲、折断和松脱;术后咬合关系、开口度、开口型恢复良好。结论克氏针治疗下颌骨髁突矢状骨折效果确切,有临床应用价值。     

Auditory canal haemorrhage following mandibular condylar fracture

A case of haemorrhage from the external auditory meatus associated with condylar fracture is presented. It is important that haemorrhage from the ear following maxillofacial injuries be investigated thoroughly because displacement of the condyle into the middle cranial fossa also presents in this manner. The patient was treated by intermaxillary fixation and packing of the auditory canal. Packing is not only effective for haemostasis but is also important in preventing subsequent stenosis of the auditory canal.     

Pattern and Prevalence of Maxillofacial Fractures in Rural Children of Central Maharashtra, India. A Retrospective Study

The aim of this study was to review the pattern and prevalence of maxillofacial fractures occurring in rural children, at Rural Dental College and Hospital, Loni, Central Maharashtra, India. A retrospective analysis of patient records and radiographs was conducted during the 5 year period between January 2005 and December 2010. Data were identified and analysed based on age group, gender and anatomic site. During the 5 year period, 156 patients with 163 maxillofacial fractures were reviewed, males formed 70 % and females formed 30 % of studied population with the peak incidence rate occurring in 10–12-year old age group. The most common fracture site in maxilla was dentoalveolar component (70 %) and in mandible common fracture site was condyle (40.9 %). Of the fractures, 43 % were from accidental fall, 24.3 % from assaults, 16 % from road traffic accidents, 13.5 % from sporting injuries and 3.2 % from other causes such as animal injuries. Our results exhibit that accidental falls were the leading cause of maxillofacial fractures, and males were three times more affected than females. There is variation of incidence and pattern of maxillofacial injuries from region to region.     

Diagnosis of jaw and dentoalveolar fractures in a traumatized patient with cone beam computed tomography

Abstract –  The purpose of this case report is to discuss and illustrate the clinical usage of Cone Beam Computed Tomography (CBCT) for the diagnosis of maxillofacial fractures in a traumatized patient. In this presentation, a 30‐year‐old male patient who was referred to Oral Diagnosis and Radiology Department with a limitation of mouth opening was reported. The history of the patient revealed a traumatic injury on his face because of a fall. The patient was initially examined by a medical practitioner in the emergency department of a public hospital. According to 2D cephalometric analysis, no fracture existed. Panoramic radiograph and postero‐anterior reverse‐town showed bilateral condyle fractures. In addition, a fracture in the left mandibular incisor region could clearly be detected on the panoramic radiograph. For further diagnosis, digital images were taken with CBCT. Cross‐sectional views showed two vertical fracture lines on the alveolar bone between teeth numbers 17, 18 and 14, 15. A palatal root fracture was observed associated with tooth number 18. A fracture line in the left mandibular incisor region as well as bilateral condyle fractures could be seen clearly on CBCT views. CBCT is becoming a popular tool in modern dental practise. In the diagnosis of dentoalveolar fractures, CBCT has made it possible for the practitioner to get more detailed information.     

Choosing the best method to utilise single positron emission computed tomography (SPECT) scans in the management of unilateral condylar hyperplasia

Facial asymmetry secondary to unilateral condylar hyperplasia can be a diagnostic challenge to oral and maxillofacial surgeons. Single positron emission computed tomography (SPECT) scans provide a useful adjunct. We report a brief summary of the evidence describing the effectiveness of different methods of analysing SPECT scans and compare it with the results of a 10-year study at Sunderland Royal Hospital. Overall, both the evidence base and our study strongly favour use of the condyle:condyle ratio over the condyle:reference bone ratio, suggesting that no further comparisons are needed.     

Intra-oral removal of ectopic third molar in the mandibular condyle

The surgical removal of impacted third molars is the most common procedure performed by maxillofacial surgeons. Only a few cases of ectopic third molars in the condyle have been reported. Most have been treated using an extra-oral or endoscopic approach. The management of this condition using an intra-oral approach (removal of this tooth and maintaining the anatomy of the condyle) is described in two case reports.