Median mandibulotomy: A critical assessment
Median mandibulotomy: A critical assessment
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正中下颌切开术：批判性评估
DOI：
10.1002/hed.2880130502
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
R. Spiro
中科院分区：
文献类型：
--
作者：
S. Dubner;R. Spiro
当肿瘤和骨之间存在正常组织时，正中下颌骨切开术（下颌骨“摆动”）已取代下颌骨切除术进入口腔和口咽肿瘤。它也被证明是有用的暴露在选定的患者深叶腮腺或咽旁间隙肿瘤。我们回顾了1959年至1988年期间进行的313例下颌骨切开术的经验，重点是适应症、并发症和技术改进。我们的大多数下颌骨切开术患者恢复顺利，但20%发生了截骨相关并发症。这些并发症通常是轻微的，没有记录到骨不连的情况。与术前或术后放疗无明显关系。仅在选定的患者（40%）中使用牙科夹板。截骨技术近年来不断发展。与正中下颌骨切开术相比，旁正中下颌骨切开术可最大限度地减少颏舌肌、颏舌骨肌和二腹肌的创伤。微型接骨板为传统钢丝固定提供了一种有用的替代方法。术前牙科评估有助于有牙患者术后更好的咬合。
Median mandibulotomy (mandibular “swing”) has supplanted mandibular resection for access to oral and oropharyngeal tumors when there is intervening grossly normal tissue between the tumor and bone. It has also proved useful for exposure in selected patients with deep lobe parotid or parapharyngeal space tumors. We have reviewed our experience with 313 mandibulotomies performed between 1959 and 1988 with emphasis on indications, complications, and modifications in technique. Most of our mandibulotomy patients had an uncomplicated recovery, but osteotomy‐related compliations occurred in 20%. These complications were usually minor and no instances of nonunion were recorded. There was no apparent relationship to antecedent or postoperative radiotherapy. Dental splints were used only in selected patients (40%). The technique of osteotomy has been evolving in recent years. Paramedian, rather than median mandibulotomy, minimizes trauma to the genioglossus, geniohyoid, and digastric muscles. Miniplates offer a useful alternative to conventional wire fixation. Preoperative dental assessment has facilitated better occlusion postoperatively in dentulous patients.