下颌骨髁突骨软骨瘤的影像学诊断及疗效评价

目的：探讨下颌骨髁突骨软骨瘤的诊治经验,恢复髁突正常的解剖形态和生理功能。方法：对1998—2008年收治的14例下颌骨髁突骨软骨瘤患者的诊治进行评价,指标包括影像学检查确诊率（X线、3D-CT及MRI）、开口度、咬合关系及术区感觉。根据检查指标进行临床诊断及手术效果评价。结果：X线、3D-CT和MRI的确诊率分别为57.1%、66.7%和87.5%。3D-CT和MRI检查能更清晰地反映肿物情况,为手术提供良好的指导。14例患者均行手术治疗,术后效果良好。结论：MRI和3D-CT检查是诊断下颌骨髁突骨软骨瘤的最佳方法,能较好地观察肿物的范围及位置关系,为手术提供良好的依据,而X线检查在下颌骨髁突骨软骨瘤的诊断中具有重要价值。

Diagnosis and surgical treatment of osteochondroma of the mandibular condyle

PURPOSE： The aim of this study was to report the experience of diagnosis and treatment of osteochondroma of the mandibular condyle, with the aim of recovering the normal anatomic structure and the physiological function. METHODS： The study included 14 cases （9 females and 5 males） with an average age of 25 years. The indexes of evaluation include final diagnosis of imageology （X-ray, 3D-CT and MRI）, maximum interincisal opening and assessment of occlusion and aesthesia of operating field. To the indexes were used to aid diagnosis and operation. RESULTS： The imageology included X-ray, 3D-CT and MRI, the final diagnosis rate was 57.1%, 66.7% and 87.5%, respectively. 3D-CT and MRI could reflex the lesion more clearly and provided guidance for the operation. All the 14 patients were treated with operation and the effectiveness was good. CONCLUSION： MRI and 3D-CT are the best methods to diagnose osteochondroma of the mandibular condyle, and can observe the range of the lesion and position relationship with adjacent tissues. X-ray also plays an important role in diagnosis. During the operation we should pay attention to recover the normal articular disc-condyle overjet and the altitude of mandibular ramus in order to recover the normal physiological function.