青少年关节镜下盘复位术后颞下颌关节间隙及髁突位置的改变

doi:10.19438/j.cjoms.2020.01.006

摘要/Abstract

摘要： 目的: 通过颞下颌关节(temporomandibular joint,TMJ)磁共振(MRI)图像测量关节间隙,比较颞下颌关节盘前移位青少年患者关节镜盘复位术前与术后关节间隙和髁突位置的变化。方法: 选取2016年1月至12月因关节盘前移位(anterior disc displacement,ADD)行关节镜盘复位术的青少年患者88例(137侧关节),在术前和随访MRI图像上对关节前、上、后间隙分别进行测量,采用SPSS 17.0软件包中的t检验、 χ²检验及Empowerstats软件中的广义相加效应模型进行统计学分析。结果: 患者手术时的平均年龄为(16.40±2.14)岁,术后平均随访(7.96±4.15)个月。术后1周,关节前间隙均值为(2.62±0.86)mm,上间隙为(4.42±1.01)mm,后间隙为(4.75±1.25)mm;关节上间隙及后间隙较术前显著增加,与随访时间呈负相关;前间隙显著减小,与随访时间呈正相关(P<0.05);术后髁突主导位置由中位(49.6%)变为前位(77.4%),并随着随访时间延长而逐渐后移。结论: 关节镜术后1周,关节上间隙及后间隙显著增加;随着随访时间延长逐渐减小,术后1年仍显著大于术前。

关键词: 颞下颌关节, 关节间隙, 髁突位置, 关节镜盘复位术, 磁共振

Abstract: PURPOSE: To compare the change of joint space and condylar position pre- and post-arthroscopic disc repositioning, and to investigate the influential factors as well as to provide useful information for surgical planning. METHODS: One hundred and thirty seven joints in 88 patients with anterior disc displacement treated with arthroscopic disc repositioning were included from January to December 2016. The widths of joint space in patients post-surgery were compared with those before surgery according to the follow-up results. Student's t test, Chi-square test and generalized additive models were used to assess the changes of joint spaces and condylar position with SPSS 17.0 and Empowerstats software package. RESULTS: The mean age at first visit was (16.40±2.14) years. The mean follow-up interval was (7.96±4.15) months. The average anterior space one week after surgery was (2.62±0.86)mm, (4.42±1.01)mm for the superior space, and (4.75±1.25)mm for the posterior space. The superior and posterior space increased significantly 1 week after arthroscopy, while the anterior space decreased significantly(P<0.05). The dominant condylar position changed from the centric(49.6%) to the anterior position(77.4%) postoperatively. Further more, the longer the follow-up time was, the more posterior the condylar position became. CONCLUSIONS: The superior space and posterior space increased significantly 1 week after arthroscopic surgery, and decreased as the following-up period got longer, but still with significant difference.

Key words: Temporomandibular joint, Joint space, Condylar position, Arthroscopic disc repositioning, MRI

中图分类号:

R782.6

詹伊宁, 胡颖恺, 马志贵, 杨驰. 青少年关节镜下盘复位术后颞下颌关节间隙及髁突位置的改变[J]. 中国口腔颌面外科杂志, 2020, 18(1): 33-37.

ZHAN Yi-ning, HU Ying-kai, MA Zhi-gui, YANG Chi. Changes of temporomandibular joint space and condylar position in adolescents after arthroscopic disc repositioning surgery[J]. China J Oral Maxillofac Surg, 2020, 18(1): 33-37.

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