髁状突疾患导致偏颌畸形外科矫治.docVIP

髁状突疾患导致偏颌畸形外科矫治 　　摘要目的:以外科方法矫治髁状突疾患导致的偏颌畸形。方法:手术矫治该类偏颌畸形8例,其中髁状突良性肥大2例,骨瘤2例,软骨瘤1例,囊肿1例,单侧下颌骨肥大2例。6例切除病变髁状突,2例单侧下颌骨肥大者切除病变髁状突并经口内切口切除患侧增生肥大的下颌缘。结果:随访1年～2.5年,无复发,6例牙合平面恢复正常,咬合关系协调稳定,面部双侧对称,外形满意。2例单侧下颌骨肥大者,面部两侧也基本对称。结论:切除病变髁状突可满意矫治髁状突疾患导致的偏颌畸形。 　　关键词 正颌外科 偏颌畸形 髁状突疾病 　　 　　杨小平,男,1963年出生,1987年西安医科大学口腔医学院颌面外科硕士研究生毕业,1995-1997年赴德国柏林自由大学专修正颌外科。现为中山医科大学口腔医学院口腔颌面外科副教授,主要从事整形、正颌及创伤外科,发表论文三十余篇,获省级科技成果奖一项。 　　 　　SURGICAL CORRECTION OF LATERAL DEVIATION OF MANDIBLE CAUSED BY CONDYLAR DISEASE 　　Yang Xiaoping Zeng Rongsheng Zheng Youhua, et al. 　　Center of Orthognathic Surgery, Stomatological College, Sun Yat-Sen University of Medical Sciences(Guangzhou510060) 　　Abstract Objective Surgical skills were used to correct lateral deviation of manadible caused by condylar disease. Methods: 8 cases of lateral deviation of mandible caused by condylar disease were corrected with operations: 2 cases of condylar heperplasia, 2 cases of osteoma, 1 case of chondroma, 1 case of cyst and 2 cases of unilateral mandibular macrognathia. The excision of sick condyle was per formed in 6 cases. In 2 cases of unilateral mandibular macrognathia, the under edge of mandible was excised besides the excision of sick condyle. Results: All the patients have been followed up 1～2.5years, there is no relapse. Very good occlusion, occlusal plane and facial contour were achieved in 6 cases. Good results were achieved in 2 cases. Conclusion: The excision of sick condyle can satis fyingly correct lateral deviation of mandible caused by condylar disease. 　　Key words Orthognathic surgery Lateral deviation of mandible Condylar disease 　　单侧髁状突疾患,如髁状突良性肥大或骨瘤,常因为髁状突的缓慢膨胀性增生而引起患侧下颌升支变长,下颌双侧明显不对称,从而导致偏颌畸形的发生,严重影响了患者的容貌美[1～4]。这类患者虽牙合平面倾斜,咬合关系紊乱,但原发病灶髁状突部位无明显症状。因此,患者常以面部不对称,要求整容的主诉而就诊,经检查才发现病因为髁状突疾患[1]。对这类疾病既要消除病因,去除病变的髁状突,又要改善面部不对称畸形,其手术治疗方法正在探索。近年来我们收治了8例该类畸形,经外科治疗取得了满意的效果。 　　 　　1 材料与方法 　　1.1一般资料本组8例中男性4例,女性4例,年龄14岁～42岁,平均27.7岁,占同期手术矫治偏颌畸形的21.1%(8/38)。 　　1.2病因、病情8例患者中6例表现为单侧髁状突增大,其中髁状突良性肥大2例,骨瘤2例,软骨瘤1例,囊肿1例。这类患