在孟加拉国一家三级医院就诊的儿科患者中,颞下颌关节强直的模式、原因和管理

A. Rahman, I. Haider
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摘要

背景:颞下颌关节(TMJ)强直是下颌髁融合颞骨盂窝的一种病理情况。它会给病人带来痛苦和残疾。本研究的目的是确定在孟加拉国达卡牙科学院和医院口腔颌面外科就诊的儿童颞颌关节强直的频率。方法:这是一项回顾性的横断面研究,涉及18例年龄在18岁以下的患者(9男9女)。数据收集自2016年1月至2018年12月的患者手术记录。结果:男女发病相同,7 - 12岁和13-18岁发病最多(n = 7, 38.89%),双侧强直(n = 11, 61.11%)多于单侧强直(n = 7, 38.89)。III型强直(34.48%)是最常见的类型(Sawhney分类)。外伤(11例,占61.10%)是儿童颞下颌关节强直的主要病因。所有患者均行手术治疗。关节间隙置换术(n = 9;50.0%)是最理想的治疗方法,其次是置换术(n = 7, 38.89%)和髁突切除术(n = 2, 11.11%)。结论:多数患者为外伤所致。大多数患者伴有面部畸形的III型强直。对于下颌骨髁突骨折和感染(中耳)必须进行绝对和适当的治疗,以防止TMJ强直。手术干预是管理TMJ强直的唯一治疗选择。积极的物理治疗是强制性的,以防止再强直,从而确保患者的生活质量。
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Temporomandibular joint ankylosis pattern, causes, and management among pediatric patient attending a tertiary hospital in Bangladesh
Background: Temporomandibular joint (TMJ) ankylosis is a pathological condition where mandibular condyle fused the glenoid fossa of the temporal bone. It causes distressing and disabling conditions to the patient. The purpose of our study is to determine the frequency of pediatric TMJ ankylosis attending at Oral and Maxillofacial Surgery Department, Dhaka Dental College and Hospital, Bangladesh. Methodology: This was a retrospective, cross-sectional study for 18 patients (9 male and 9 female) aged up to 18 years old. Data assembled from the patient's surgical records reviewed from January 2016 to December 2018. Results: Females and males were affected equally, the most affected age group was 7–12 as well as 13–18 years old (n = 7, 38.89%), bilateral ankylosis (n = 11, 61.11%) was more common than unilateral (n = 7, 38.89). Type III (34.48%) ankylosis (Sawhney's classification) was found to be the most frequent type. Trauma (n = 11, 61.10%) was the major etiologic factor for pediatric TMJ ankylosis. All patients were managed by surgical intervention. Gap arthroplasty (n = 9; 50.0%) was the most preferable treatment method followed by interpositional arthroplasty (n = 7, 38.89%) and condylectomy (n = 2, 11.11%). Conclusion: The majority of the patient was affected by trauma. Most of the patients came with Type III ankylosis with having facial deformities. Absolute and proper management regarding mandibular condylar fracture and infection (middle ear) must be required to prevent TMJ ankylosis. Surgical intervention is the only treatment option for managing TMJ ankylosis. Aggressive physiotherapy is mandatory to prevent reankylosis, thus ensuring the patient's quality of life.
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