下颌髁突骨瘤的外科治疗

作者为介绍髁突骨瘤不同的外科手术治疗方法及其适应证。总结了５种不同的手术方法治疗２３例髁突骨瘤。①单纯切除下颌髁突骨瘤５例；②患侧下颌升支垂直截骨，体外切除髁突骨瘤后升支再植入１２例；③第２类术式加口内进路健侧升支垂直截骨术２例；④ＬｅＦｏｒｔⅠ型截骨术摆正平面，双侧升支垂直截骨术及颏成形术５例；⑤一期切除巨大髁突骨瘤，二期下颌升支缺损修复术１例。作者强调，正常的解剖形态和解剖关系是恢复正常生理功能的基础，因此认为单纯切除髁突骨瘤不是理想的术式。多种正颌外科技术可用于髁突骨瘤的手术治疗中，畸形涉及上颌的病例应采用双颌手术，以获得良好的功能及外科效果。

Surgical treatment of the condylar osteoma

The purpose of the paper is to present different procedures for condylar osteoma surgery and their indications. Five surgical procedures were used for the treatment of 23 cases of condylar osteoma: 1. Simple resection of the condyle and osteoma for 5 cases. 2. EVRO of the effected side and resection of the condyle and osteoma for 12 cases. 3. Procedure 2 plus IVRO of the contra-lateral side for 2 cases. 4. LeFort I osteotomy for correction of the upper occlusal plane, vertical ramus osteotomy bilaterally and genioplasty for 5 cases. 5. One stage resection of the huge condylar osteoma, and repair of the defective ramus in second stage. It is emphasized that good function is based on the normal anatomical relationship of jaws and TMJs, so simple resection of the condyle and osteoma without repair is not an ideal surgery. Various orthognathic surgical techniques could be used in the therapy of condylar osteoma. While the deformity involves maxilla, two jaw surgery is indicated for better results on function and appearance.