双侧陈旧性颞下颌关节脱位诊疗经验总结OACSTPCD

Objective:To explore and summarize the characteristics,therapeutic regimens,and prognosis of chronic protracted mandibular dislocation(CPMD)in our hospital in order to provide the clinical references for prevention and treat-ment of CPMD.Methods:Retrospective analysis of 9 clinic cases diagnosed with CPMD hospitalized in our hospital from December 2019 to May 2023.To analyze and summarize the basic data,dislocation type,dislocation duration,clinical repre-sentations,risk factors,patients'conscious state,reduction method,reduction time,hospital stays,and complications.The mouth opening,occlusion,and joint stability in followed-up period were also analyzed.Results:The average age of 9 patients was(67±11.3)years,and 88.9％were females.All the patients been diagnosed with bilateral anterior dislocation whose dura-tion of dislocation was(2.1±1.4)months.Nervous system injuries were the most closely related risk factor for CPMD.About 77.8％cases shown unconscious during CPMD onset,only 22.2％patients had the immediate perception of dislocation.A-bout 88.9％cases of CPMD were closely related to medical activities.Manual reduction was performed in 8 cases under anes-thesia with an average time of(24.3±10.9)minutes and the manual reduction rate was 88.9％,besides 1 case were treated with surgery method.All the patients received elastic intermaxillary traction after reduction,normal occlusion and mouth open-ing,no re-dislocation and complications were found in manual reduction,besides the condition of slight limitation and facial nerve injury in surgery case.Conclusion:CPMD is mainly secondary to nervous system injuries with unconsciousness.Manual reduction under general anesthesia combined with elastic traction using traction nail is the preferred and effective treatment of CPMD,but surgery reduction is still available if necessary.