目的 探讨计算机导航技术在口内喙突切除入路髁突切除术中的应用.方法 在计算机导航技术辅助下,采用口内喙突切除入路共完成8例患者的髁突病变切除手术治疗,患者年龄16 ~56岁,男性2例,女性6例,其中3例为髁突骨瘤,5例为半侧颌骨肥大畸形伴发的髁突良性肥大.6例同期进行上颌LeFoa Ⅰ型截骨术、5例双侧下颌升支矢状劈开截骨术、1例健侧下颌升支矢状劈开截骨术、4例颏成形术及6例下颌骨体或下颌角修整术,以恢复面部的对称性.结果 经术后CT验证,所有患者均按术前设计方案成功完成了髁突病变切除术,术后咬合关系、面部对称性恢复良好,颞下颌关节疼痛及弹响症状减轻或消失.开口度术前平均38 mm,术后1个月恢复为41 mm.患者随访3 ~12个月,疗效稳定.结论 计算机导航技术可精确辅助完成口内入路的髁突切除术,手术创伤小,能较好地保存颞下颌关节的结构及功能.
Objective To assess the application of computer assisted surgical navigation in condylectomy via intraoral approach and its clinical results.Methods Eight patients aged from 16 to 56 were treated by condylectomy via intraoral approach under computer assisted surgical navigation.There were 6 famale and 2 male.The lesions were condyle osteoma in 3 patients,hemimandibular hyperplasia and condylar hyperplasia in 5 patients.Most patients had concomitant LeFort Ⅰ osteotomy(6 cases),bilateral sagittal split ramus osteotomy (BSSRO) (5 cases),contralateral sagittal split ramus osteotomy (SSRO) (1 cases),genioplasty (4 cases) and mandible contouring (6 cases) to recover the facial symmetry.Results All patients had good occlusion,oral function and facial symmetry after the operation.The arerage mouth opening was 38 mm before operation,and 41 mm one month after operation.The temporomandibular joint (TMJ) dysfunction syndrome alleviated or disappeared.The follow-up period was 3-12 months,and results were stable.Conclusions Computer assisted surgical navigation can precisely accomplish the condylectomy via intraoral approach.It causes less trauma to the patient than traditional condylectomy,and can better preserve the TMJ structure and function.