Prolonged mandibular hypomobility patient with a "square mandible" configuration with coronoid process and angle hyperplasia
Prolonged mandibular hypomobility patient with a "square mandible" configuration with coronoid process and angle hyperplasia
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DOI：
10.1080/08869634.2000.11746122
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发表时间：
2000-04-01
影响因子：
1.6
通讯作者：
Iizuka, T
中科院分区：
文献类型：
--
作者：
Murakami, K;Yokoe, Y;Iizuka, T
本研究的目的是对方形下颌形态伴冠突和角增生的慢性严重下颌活动能力低下患者进行手术治疗，并报告了一年的随访数据。对10例患者进行了研究。所有患者均为女性，有逐渐严重的下颌活动迟缓史。临床结果与“闭锁”患者相似。然而，这些患者的面部外观表现为典型的方形下颌面部结构。冠突增厚和下颌角过度生长在x线表现明显。诊断成像几乎没有描述任何椎间盘紊乱，但严重受限的颌骨开口被注意到，尽管可以接受的游离颌骨运动。先行双侧冠状窦切开术或冠状窦切除术，再经口内入路剥咬肌。成功减少下颌不动后，完成选择性下颌角切除术。术后3 - 5天内开始物理治疗，术后询问所有患者的颌功能和对治疗的主观评价。用以毫米为单位标记的尺子记录下颌内开口。所有患者均行双侧冠状动脉切除术或冠状动脉切除术加咬肌剥离术；其中7例在13个部位行下颌角切除术，3例在3个关节同时行TMJ手术。大多数患者反映颌骨功能改善，患者主观评价平均满意率为74.6%。术前平均颌骨开口距离为25.6 mm，术后随访1年增至36.6 mm (p
The objective of this study was the surgical management of chronic severe mandibular hypomobility patients associated with square mandible morphology with coronoid process and angle hyperplasia, and one-year follow-up data is reported. Ten patients were studied. All patients were female and had a history of gradual severe jaw hypomobility. Clinical findings were similar to those of a "closed lock" patient. However, the facial appearance in these patients showed a characteristic square mandible facial configuration. Coronoid process thickening and overgrowth of the mandibular angle was evident in the radiographic findings. Diagnostic imaging scarcely depicted any disk derangement, but a severely limited jaw opening was noted in spite of acceptable excursive jaw movements. Bilateral coronoidotomy or coronoidectomy was done initially, and then masseter muscle stripping via the intraoral approach. After successful reduction of jaw hypomobility, a selective mandibular anglectomy was completed. Physical therapy began within three to five days after the surgery, Postoperatively, all patients were questioned about their jaw function and their subjective assessment of the treatment. Interincisal jaw opening was recorded with a ruler marked in millimeters. Bilateral coronoidotomy or coronoidectomy and masseter muscle stripping were done for all patients; the mandibular anglectomy was performed in seven of the cases at 13 sites, Simultaneous TMJ surgery was done on three joints for three patients. Most patients reported improvement of jaw function, and the patients' subjective assessment revealed an average satisfaction rate of 74.6%. A preoperative mean jaw opening distance of 25.6 mm increased to 36.6 mm postoperatively at a one-year follow-up (p