单侧后牙反(牙合)患者髁状突及下颌升支对称性的螺旋CT研究

目的：探讨单侧后牙反[牙合]成年患者髁状突及下颌升支的对称性。方法：对22例单侧后牙反[牙合]患者进行螺旋CT扫描、多层面重建和相关参数测量,并进行统计分析。结果：双侧髁突内、外突面积的差异无统点的距离,髁突内倾角及下颌角点的距离有显著差异,但髁突左右径、髁状突最大横截面积、下颌支高度及下颌支冠状位最大计学意义。结论：单侧后牙反[牙合]患者左右侧髁状突及下颌支的位置不对称,但髁突及下颌升支大小无显著差异。     

可吸收缝线缝合固定法治疗胫骨髁间嵴撕脱性骨折

我科1998年6月-2002年12月，采用Maxon可吸收缝线作前交叉韧带基底部Bunnell缝合固定法治疗胫骨髁间嵴撕脱性骨折22例，取得了满意的疗效，现报告如下。     

The learning curve of transoral condylectomy; a retrospective analysis of 100 consecutive cases of unilateral condylar hyperplasia

In this study, 100 consecutive scheduled transoral condylectomies for unilateral condylar hyperplasia were included. The safety and surgical performances were assessed, using the operating time, conversion rate and complication rate. The conversion rate learning curve was evaluated with a learning curve cumulative summation (LC-CUSUM).The total conversion rate was 8.0%. The LC-CUSUM for conversion signaled at the 53th procedure, indicating sufficient evidence had accumulated that the surgeon had achieved competence. For procedures 54–100, the conversion rate was 4.0%. The operating time for the transoral condylectomy was 41.5 ± 15.3 min; when a conversion was necessary, the operating time was 101.4 ± 28.3 min (p < 0.05). The estimated operating time in the post-learning phase was 37 min, this was reached after approximately 47 procedures. There was 1 major complication of a permanent inferior alveolar nerve hypoesthesia. The complication rate was not significantly decreased after the learning curve.Within the limitations of the study, it seems that transoral condylectomy for UCH is a safe procedure with several advantages over the traditional preauricular approach. Surgeons starting this procedure should be aware of the potential complications and of the learning curve of approximately 53 procedures.