口腔疾病防治2016，Vol.24Issue(10)：567-573,7.DOI:10.12016/j.issn.2096-1456.2016.10.002
颞下颌关节肿瘤及瘤样病变致颜面部畸形的手术治疗
Surgical treatment for facial deformity caused by temporomandibular joint tumors and condylar tumor-like le-sions
摘要
Abstract
Objective To investigate the effective surgical methods for facial asymmetrical deformity caused by temporomandibular joint tumors and condylar tumor-like lesions as well as the post-surgical influence on cosmetic as-pects and occlusal function. Methods The study included 82 cases with temporomandibular joint tumors and condylar tumor-like lesions from 1995 to 2015 in the Hospital of Stomatology, Sun Yat-sen University. Among them, 54 cases (65.9%) were diagnosed with benign tumor, 25 cases (30.5%) with tumor-like lesions (hyperplasia of condyle) and 3 cas-es with malignant neoplasm (3.7%). 61 cases with the chief complaint of progressive facial deformity underwent surger-ies, including: simple resection of neoplasms and hyperplasia condyle for 34 cases; resection of neoplasms plus repair with costochondral graft for 9 cases; vertical ramus osteotomy of the affected side (EVRO) and re-implantation of con-dyle after tumor excision for 3 cases;subcondylar ramus"L"-shaped osteotomy for 3 cases;bilateral ramus vertical oste-otomy for 4 cases; bilateral sagittal split ramus osteotomy for 3 cases; bilateral sagittal split ramus osteotomy (BSSRO) plus LeFortⅠosteotomy for correction of the upper occlusal plane for 3 cases. Resection of partial or hemimandible for 2 cases. All patients were followed up from 6 months to 10 years after operation. Results During the follow-up period, no recurrence was found in the 58 cases with benign tumor, and 53 cases got satisfactory restoration in appearance and occlusal function. Among the cases who underwent simple resection of tumors and condyle, two patients appeared a seri-al of clinical symptoms because of unstable occlusal relationship, three cases did not obtain satisfied appearance. Among the three cases with malignant neoplasm, two cases got stable results and one died. Conclusion Simple resec-tion of the temporomandibular joint neoplasms is the main surgical methods for facial asymmetrical deformity caused by temporomandibular joint tumors and condylar tumor-like lesions. But results of some cases are not satisfied. Compre-hensive surgical techniques could be applied in the treatment of asymmetric deformity of face based on different scenari-os to improve the appearance, occlusal relationship and temporomandibular joint function.关键词
颞下颌关节/肿瘤/瘤样病变/髁状突增生/手术治疗Key words
Temporomandibular joint/Neoplasm/Tumor-like lesions/Condyle hyperplasia/Surgery分类
医药卫生引用本文复制引用
郑有华,张志光,曾融生,杨小平,何一青,苏凯..颞下颌关节肿瘤及瘤样病变致颜面部畸形的手术治疗[J].口腔疾病防治,2016,24(10):567-573,7.基金项目
卫生部部属（管）医院临床学科重点项目 （）
