口腔医学研究 ›› 2016, Vol. 32 ›› Issue (5): 464-469.DOI: 10.13701/j.cnki.kqyxyj.2016.05.010

• 临床研究论著 • 上一篇    下一篇

改良耳颞-结膜-口内联合切口治疗眼眶-上颌-颧骨、颧弓复合体骨折

克热木·阿巴司 ,凌彬 ,买买提吐逊·吐尔地, 林兆全 ,龚忠诚*   

  1. 新疆医科大学第一附属医院颌面肿瘤外科 新疆 乌鲁木齐 830054
  • 收稿日期:2015-10-23 出版日期:2016-05-26 发布日期:2016-05-26
  • 通讯作者: 龚忠诚,E-mail:gump0904@aliyun.com
  • 作者简介:克热木·阿巴司(1978~ ),男,维吾尔族,新疆人,硕士,主治医师,主要从事口腔颌面部创伤及脉管性疾病研究。
  • 基金资助:
    2012年国家自然科学基金(地区科学基金)(项目号:31260229)

Application of Modified Preauricular and Temporal-conjunctival-intraoral Incision Approach in the Treatment of Orbital-maxillary-zygomatic Complex Fractures.

KE Re-mu·A Ba-si, LING Bin, MAI MAI-ti·TU ER-xun, LIN Zhao-quan, GONG Zhong-cheng*.   

  1. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China
  • Received:2015-10-23 Online:2016-05-26 Published:2016-05-26

摘要: 目的:探讨对眼眶-上颌-颧骨、颧弓复合体骨折采用改良耳颞-结膜-口内联合切口,行骨折切开复位内固定术。方法:170例患者分为两组:对照组(88例)采用常规冠状-睑下缘-口内联合切口,实验组(82例)采用改良耳颞-结膜-口内联合切口,均行骨折切开复位内固定术。比较两组患者的手术时间、术中出血量、切口长度、术后切口肿胀及瘢痕程度、术后局部积液、面神经及眶下神经功能、耳颞区感觉功能、泪道损伤发生率、下眼睑外翻及颞部凹陷的发生率、骨折复位的效果、患者满意度,综合评价治疗效果。结果:两组患者手术时间、术中出血量、切口平均长度、术后切口肿胀及瘢痕程度、术后局部积液、面神经功能障碍、耳颞区感觉障碍、泪道损伤发生率、下眼睑外翻及面颞部凹陷的发生率、患者满意度比较具有显著性差异(P<0.05)。两组患者眶下神经功能、骨折复位的效果比较无显著性差异。结论:改良耳颞-结膜-口内联合切口具有切口隐蔽,损伤小,并发症少等优点,值得在临床上进一步推广应用。

关键词: 眼眶-上颌-颧骨, 颧弓复合体骨折, 改良耳颞-结膜-口内联合切口, 切开复位内固定术

Abstract: Objective: To compare treatment effectiveness between modified preauricular and temporal-conjunctival-intraoral united incision and coronal-subciliary-intraoral united incision in treating orbital-maxillary-zygomatic(OMZ) complex fractures. Methods: 170 cases of OMZ complex fractures were divided into two groups. 88 cases in the control group were treated via coronal-subciliary-intraoral united incision,and 82 cases in the test group were treated via modified preauricular and temporal-conjunctival-intraoral united Incision. Both groups were reducted and fixed with titanium-plates. We compared the treatment results of two groups including the operation time, operative blood loss, the length of the incision, the degree of swelling and post-operative incision scar, wound effusion, facial nerve function, orbital nerve function, the sensory function of the preauricular and temporal region, the incidence rate of Lacrimal duct injury and the lower eyelid ectropion, the incidence of depression of the temporal region, the effect of rigid internal fixation, and the degree of patient satisfaction. Results: There were less time of operation, less loss of operative blood, shorter length of incision, less tissue reaction, less scar, less wound effusion, less incidence of facial nerve and the sensory dysfunction of the preauricular and temporal region, less incidence rate of Lacrimal duct injury, lower eyelid ectropion and depression of the temporal region, but more patient satisfaction in test group than those in control group (P<0.05). There was no significant difference in the effect of rigid internal fixation and the incidence of orbital nerve dysfunction between two groups. Conclusion:The modified preauricular and temporal-conjunctival-intraoral united incision shows advantages of indistinguishable incison, slight injury and less complications.

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