口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (6): 361-367.DOI: 10.12016/j.issn.2096-1456.2021.06.001

• 专家论坛 • 上一篇    下一篇

髁突良性肥大的诊断和治疗

王安训()   

  1. 中山大学附属第一医院口腔颌面外科, 广东 广州(510080)
  • 收稿日期:2020-02-19 修回日期:2020-10-10 出版日期:2021-06-20 发布日期:2021-04-12
  • 通讯作者: 王安训
  • 基金资助:
    广东省自然科学基金面上项目(2020A151501091)

Diagnosis and treatment of benign condylar hyperplasia

WANG Anxun()   

  1. Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2020-02-19 Revised:2020-10-10 Online:2021-06-20 Published:2021-04-12
  • Contact: Anxun WANG
  • Supported by:
    grants from Guangdong Basic and Applied Basic Research Foundation(2020A151501091)

摘要:

髁突良性肥大是引起偏颌畸形的原因之一,临床上易于误诊,导致治疗的失败。本文根据文献资料并结合课题组的临床经验,详细阐述髁突良性肥大的病因、临床表现、诊断要点和治疗进展,为临床规范化治疗髁突良性肥大提供循证医学证据。髁突良性肥大病因包括神经营养障碍、局部循环障碍、外伤特别是幼年时期的髁突损伤、偏侧咀嚼、颞下颌关节炎、内分泌障碍、髁突骨瘤、遗传等;髁突良性肥大隐匿发病;好发于10~30岁;病程可持续多年。其临床特点为缓慢进行性颌面部不对称。放射性核素骨扫描是髁突良性肥大诊断、鉴别诊断和制定治疗方案的基础,临床需针对活动期和非活动期制定不同的治疗方案,包括密切观察、比例髁突切除术和正颌手术。

关键词: 髁突, 髁突损伤, 偏侧咀嚼, 骨代谢, 良性肥大, 下颌骨, 偏颌畸形, 诊断, 核素扫描, 治疗, 手术

Abstract:

Benign condylar hyperplasia is one of the causes of mandibular lateral deformity, it is easily to be misdiagnosed clinically and leads to the treatment failure. This article will elaborate the etiology and clinical features of benign condylar hyperplasia, as well as the diagnostic points and treatment progress, based on the literature and the clinical experience of our research group, to provide evidence-based medical evidence for the standardized clinical treatment of benign condylar hyperplasia. The etiology of benign condylar hypertrophy includes neurotrophic disorders, local circulatory disorders, traumatic injuries (especially condylar injuries that occur in childhood), unilateral mastication, temporomandibular arthritis, endocrine disorders, condylar osteoma, and heredity. Benign condylar hypertrophy is insidious, and occurs most frequently in individuals 10-30 years old, and the course of disease can last for many years. Its clinical characteristics are slow progressive facial asymmetry. Radionuclide bone scans have become the basis for the diagnosis and differential diagnosis of and treatment planning for benign condylar hypertrophy. Different treatment plans for active and inactive periods need to be developed, including close observation, proportional condylar resection and orthognathic surgery.

Key words: condyle, injuries of condyle, unilateral mastication, bone metabolism, benign hyperplasia, mandible, mandibular lateral deformity, diagnosis, radionuclide scanning, treatment, operation

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