악관절 강직증에 관한 임상적 연구
Clinical study of temporomandibular joint ankylosis
송민석, 김경호,
소속 상세정보
송민석 ( ) - 서울대학교 치과대학 소아치과학교실
김경호 ( ) - 서울대학교
KMID : 0360119950170010060
Abstract
Temporomandibular joint ankylosis is the movemental obstacle of mandible witch depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been
performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset,
duration,
anesthesia and treatment method, symptom, change of mouth opening, complication through medical record. X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis.
The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul
National
University Hospital.
1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average age of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period on illness was 13.33% years.
2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation.
3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40,9% and the cases of using tracheostomy occupied 18.2%.
4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap
ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy(Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 35.6%.
5. In change of mouth opening reformed after surgery. Group III showed the best result of average 23.5%mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation.
Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining
anatomaical & functional form. and then the development of various surgical methods will be requested.
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