标准型颞下颌关节假体置换术中保存翼外肌附着的效果评价

doi:10.19438/j.cjoms.2022.06.005

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (6): 548-553.doi: 10.19438/j.cjoms.2022.06.005

标准型颞下颌关节假体置换术中保存翼外肌附着的效果评价

岳史婧^*, 赵炅^*, 白果, 陈敏洁^#, 杨驰^#

上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011

收稿日期:2022-01-07 修回日期:2022-06-12 出版日期:2022-11-20 发布日期:2022-11-20
通讯作者: 杨驰,E-mail: yangchi63@hotmail.com;陈敏洁,E-mail: chenminjie00@126.com。^#共同通信作者
作者简介:岳史婧（1997-）,女,在读博士研究生,E-mail: shijingy13@163.com;赵炅（1997-）,女,在读硕士研究生,E-mail: jiong64@163.com。*并列第一作者
基金资助:
中国医学科学院医学与健康科技创新工程项目（2019-I2M-5-037）; 上海市科委公共服务平台项目（21DZ2292000）

Preliminary clinical evaluation of lateral pterygoid muscle preservation in total temporomandibular joint reconstruction with stock prosthesis

YUE Shi-jing, ZHAO Jiong, BAI Guo, CHEN Min-jie, YANG Chi

Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2022-01-07 Revised:2022-06-12 Online:2022-11-20 Published:2022-11-20

摘要/Abstract

摘要： 目的探讨标准型颞下颌关节假体置换术中保存翼外肌(lateral pterygoid muscle, LPM)附着的临床效果。方法提出一种优化髁突截骨而在标准型关节假体置换手术中将翼外肌保留在翼肌窝上的新方法,并与常规术式相比较,验证该肌肉保存、重建新方法的可行性和有效性。采用SPSS 25.0软件包对数据进行统计学分析。结果本回顾性研究纳入12例使用标准型人工关节完成关节置换手术的患者,其中,LPM(+)组有7侧关节使用新方法保存翼外肌,LPM(-)组有7侧关节采用常规髁突截骨不保存翼外肌。手术后,LPM(+)组下颌侧方运动功能恢复显著改善,平均侧方运动距离为3.14 mm;而 LPM(-)组仅为0.29 mm (P<0.01)。中长期随访结果显示,LPM(+)组术后骨愈合良好,翼外肌位置稳定。结论翼外肌功能重建有利于颞下颌关节置换术后患者的下颌运动功能恢复,这种新方法可有效保存翼外肌,维持翼外肌功能。

关键词: 翼外肌保存, 假体置换, 颞下颌关节

Abstract: PURPOSE: To investigate the clinical effect of retaining lateral pterygoid muscle (LPM) during standard temporomandibular joint（TMJ） prosthesis replacement. METHODS: A new method that LPM was kept attached to the pterygoid muscle fossa through proper condyle osteotomy was tried to preserve LPM during total joint reconstruction (TJR). Compared with the conventional operation, the feasibility and effectiveness of the new method for muscle preservation and reconstruction were verified. SPSS 25.0 software package was used for data analysis. RESULTS: Twelve patients with a total of 14 joints undergoing TJR with LPM preservation were included in this retrospective study. Lateral movement of all 7 joints in LPM(+) group that preserved LPM were restored post-operation, with an average 3.14 mm of lateral moving distance, much higher than that in LPM(-) group (0.29 mm, P<0.01). In addition, bone healed well and LPM located stably. CONCLUSIONS: LPM preservation is essential for function regain of mandible lateral movement post TJR operation and this new method can be utilized to preserve LPM.

Key words: Lateral pterygoid muscle preservation, Total joint reconstruction, Temporomandibular joint

中图分类号:

R782.6

岳史婧, 赵炅, 白果, 陈敏洁, 杨驰. 标准型颞下颌关节假体置换术中保存翼外肌附着的效果评价[J]. 中国口腔颌面外科杂志, 2022, 20(6): 548-553.

YUE Shi-jing, ZHAO Jiong, BAI Guo, CHEN Min-jie, YANG Chi. Preliminary clinical evaluation of lateral pterygoid muscle preservation in total temporomandibular joint reconstruction with stock prosthesis[J]. China J Oral Maxillofac Surg, 2022, 20(6): 548-553.

参考文献

[1] Liu F, Steinkeler A.Epidemiology, diagnosis, and treatment of temporomandibular disorders[J]. Dent Clin North Am, 2013, 57(3): 465-479.
[2] Yoda T, Ogi N, Yoshitake H, et al.Clinical guidelines for total temporomandibular joint replacement[J]. Jpn Dent Sci Rev, 2020, 56(1): 77-83.
[3] Sidebottom AJ, UK TMJ Replacement Surgeons. Guidelines for the replacement of temporomandibular joints in the United Kingdom[J]. Br J Oral Maxillofac Surg, 2007, 46(2): 146-147.
[4] Hu Y, Zhang L, He D, et al.Simultaneous treatment of temporomandibular joint ankylosis with severe mandibular deficiency by standard TMJ prosthesis[J]. Sci Rep, 2017, 7: 45271.
[5] Park JH, Jo E, Cho H, et al.Temporomandibular joint reconstruction with alloplastic prosthesis: the outcomes of four cases[J]. Maxillofac Plast Reconstr Surg, 2017, 39(1): 1-6.
[6] Xu X, Ma H, Jin S.One-stage treatment of giant condylar osteoma: alloplastic total temporomandibular joint replacement aided by digital templates[J]. J Craniofac Surg, 2018, 29(3): 636-639.
[7] Machon V, Hirjak D, Beno M, et al.Total alloplastic temporomandibular joint replacement: the Czech-Slovak initial experience[J]. Int J Oral Maxillofac Surg, 2011, 41(4): 514-517.
[8] Lotesto A, Miloro M, Mercuri LG, et al.Status of alloplastic total temporomandibular joint replacement procedures performed by members of the American Society of Temporomandibular Joint Surgeons[J]. Int J Oral Maxillofac Surg, 2016, 46(1): 93-96.
[9] Mercuri LG.Costochondral graft versus total alloplastic joint for temporomandibular joint reconstruction[J]. Oral Maxillofac Surg Clin North Am, 2018, 30(3): 335-342.
[10] Bai G, He D, Yang C, et al.Application of digital templates to guide total alloplastic joint replacement surgery with biomet standard replacement system[J]. J Oral Maxillofac Surg, 2014, 72(12): 2440-2452.
[11] Carpentier P, Yung JP, Marguelles-Bonnet R, et al.Insertions of the lateral pterygoid muscle: an anatomic study of the human temporomandibular joint[J]. J Oral Maxil Surg, 1988, 46(6): 477-482.
[12] Rasse M, Kermer C, Undt G.Functional reconstruction in a case of osteoblastoma of the mandibular condyle[J]. Int J Oral Marillofac Surg, 1996, 25(5): 344-345.
[13] Collins CP, Wilson KJ, Collins PC.Lateral pterygoid myotomy with reattachment to the condylar neck: an adjunct to restore function after total joint reconstruction[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 95(6): 672-673.
[14] 王翔宇, 白果, 董敏俊, 等. 保存翼外肌附着的颞下颌关节肋骨-肋软骨移植重建术效果评[J]. 中国口腔颌面外科杂志, 2018, 16(5): 420-424.
Wang XY, Bai G, Dong MJ, et al.Effect of modified costochondral graft in temporomandibular joint reconstruction with lateral pterygoid muscle preservation technique[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(5): 420-424.

[1]	李响, 丁若仪, 王秀梅, 何冬梅, 王冬梅. 标准型人工颞下颌关节假体在开口运动中的特征分析[J]. 中国口腔颌面外科杂志, 2024, 22(4): 353-359.
[2]	李晨曦, 方昌, 龚忠诚, 邵博. 累及颞下颌关节整体结构的软骨黏液样纤维瘤：手术切除及关节重建1例报告[J]. 中国口腔颌面外科杂志, 2024, 22(4): 409-412.
[3]	米娜, 安玮, 金雪梅, 谢帅, 姚志涛. 叶黄素对兔创伤性颞下颌关节强直的预防作用研究[J]. 中国口腔颌面外科杂志, 2024, 22(3): 216-221.
[4]	何美娟, 夏滴, 白果, 赵界云, 俞蕾蕾, 顾雅洁. 多学科协作模式在颞下颌关节强直肋骨肋软骨重建术患者护理中的应用[J]. 中国口腔颌面外科杂志, 2023, 21(6): 553-558.
[5]	陈云亮, 满城, 李晓宇, 伍靖, 魏柳琼, 李文龙. 创伤性颞下颌关节强直与异位骨化发病机制相似性的实验研究[J]. 中国口腔颌面外科杂志, 2023, 21(5): 461-466.
[6]	邓李妮, 陈传俊, 王祎, 项先旺. 颞下颌关节二水焦磷酸钙结晶沉积症1例报告及文献复习[J]. 中国口腔颌面外科杂志, 2023, 21(5): 522-525.
[7]	余也可, 丁若仪, 孙家莉, 张志愿, 何冬梅. 大鼠颞下颌关节骨关节炎中髁突软骨与骨髓的单细胞转录组分析[J]. 中国口腔颌面外科杂志, 2023, 21(4): 332-339.
[8]	闫婷婷, 张静, 庄立琨, 王莉莉, 张鹏, 袁荣涛. 脂多糖对大鼠三叉神经节Nav1.7表达的调控及机制研究[J]. 中国口腔颌面外科杂志, 2023, 21(4): 345-351.
[9]	吾尔古丽·阿力甫, 热伊莱·阿不都克热木, 柳江龙, 买买提吐逊·吐尔地. 双线锚固钉在颞下颌关节盘锚固术中的应用效果评价[J]. 中国口腔颌面外科杂志, 2023, 21(4): 397-402.
[10]	李莉玫, 朱耀旻, 王昱萌, 戴娟, 张丹迪, 梁潇. 23例颞下颌关节手术联合面部除皱术临床疗效分析[J]. 中国口腔颌面外科杂志, 2022, 20(6): 554-559.
[11]	陈静, 朱敏. 稳定型咬合板联合关节灌洗术治疗颞下颌关节紊乱病的疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(6): 565-570.
[12]	张大河, 沈佩, 杨驰. 青少年颞下颌关节盘前移位患者就诊情况分析[J]. 中国口腔颌面外科杂志, 2022, 20(5): 437-442.
[13]	张大河, 沈佩, 杨驰. 青少年颞下颌关节盘前移位患者就诊情况分析[J]. 中国口腔颌面外科杂志, 2022, 20(5): 443-448.
[14]	马志贵, 沈佩, 戈旌, 谢千阳, 赵宁, 董敏俊, 杨驰. 多学科协作教学模式在颞下颌关节病实践教学中的应用[J]. 中国口腔颌面外科杂志, 2022, 20(5): 500-504.
[15]	李辉, 黄林剑, 谢千阳, 杨驰. 体外培养的兔下颌骨髁突对机械压力的反应和变化[J]. 中国口腔颌面外科杂志, 2022, 20(4): 340-346.

标准型颞下颌关节假体置换术中保存翼外肌附着的效果评价

Preliminary clinical evaluation of lateral pterygoid muscle preservation in total temporomandibular joint reconstruction with stock prosthesis

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价