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目的:回顾我院应用牵张成骨序列治疗颞下颌关节强直及继发颌面部畸形的效果。方法:40例关节强直患者,平均年龄24.5岁(9~53岁),其中单侧强直11例,双侧29例,伴发OSAHS者27例。所有患者一期手术牵张成骨,二期手术拆除牵张器并同期行颞下颌关节成形术,同期或三期行正颌手术改善面部外形。通过术前术后最大张口度、面型及打鼾症状改善情况评估治疗效果。结果:关节成形术后40例患者张口度基本恢复正常,面型均得到显著改善,打鼾症状全部消失。经过4~72个月(平均20.5个月)的随访,4例患者关节强直复发。结论:应用一期牵张成骨二期关节成形治疗颞下颌关节强直及继发畸形能够精确控制面型和气道的改变。
Objective: To review the effect of distraction osteogenesis in our hospital for the treatment of temporomandibular joint ankylosis and secondary maxillofacial deformity. Methods: Forty patients with ankylosing spondylitis (mean age 24.5 years (range, 9-53 years), including 11 cases of unilateral stiffening, 29 cases of bilateral and 27 cases of OSAHS. All patients underwent primary distraction osteogenesis, secondary distraction distraction mandibular arthroplasty, and orthognathic surgery in the same or three phases to improve facial appearance. Preoperative and postoperative maximal mouth opening, face and snoring symptoms to improve the situation to assess the therapeutic effect. Results: After 40 cases of arthroplasty, the degree of mouth opening returned to normal, the shape of the face was significantly improved, and all the symptoms of snoring disappeared. After 4 to 72 months (mean 20.5 months) follow-up, 4 patients had recurrent ankylosis. Conclusion: The application of one-stage distraction osteogenesis secondary arthroplasty in the treatment of temporomandibular joint ankylosis and secondary deformity can precisely control the changes of facial and airway.