BACKGROUND The diagnosis of coronoid process hyperplasia(CPH)is usually based on symptoms and radiological imaging.Because of its similar symptoms,it can be confused with temporomandibular joint diseases.Therefore,an ...BACKGROUND The diagnosis of coronoid process hyperplasia(CPH)is usually based on symptoms and radiological imaging.Because of its similar symptoms,it can be confused with temporomandibular joint diseases.Therefore,an objective and reproducible way of diagnosis should be determined.AIM To investigate CPH using Levandoski analysis on panoramic radiographs to determine its prevalence.METHODS A total of 300 panoramic radiograph images(600 coronoid processes)were examined.Having measured the Condyle-Gonion(Cd-Go)and Coronoid-Gonion(Cor-Go)distances,the Cor-Go:Cd-Go ratio was calculated for the left and right sides of each image.RESULTS There was a statistically significant difference in Cd-Go and Cor-Go distances between male and female participants(P<0.001).There was no statistically significant relationship between Cor-Go:Cd-Go ratios and gender(P>0.05).CONCLUSION Cd-Go and Cor-Go distances were statistically significantly increased in males on both the left and right sides.The ratio of Cor-Go:Cd-Go was preserved in both genders.The prevalence of CPH was found to be 0.3%.展开更多
Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures sur...Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures surgically fixed in our institution using a buttress plate technique via a medial approach between June 2012 and April 2015 by the senior author was performed.These fractures were all sizeable fractures contributing to persistent elbow instability in terrible triad or varus posteromedial rotatory instability injury patterns.A prospective telephone questionnaire was conducted to assess patient outcomes using the disabilities of the arm,shoulder and hand(DASH)score and Mayo hlbow performance score(MEPS).Results:Twelve patients were included in the study,comprising 10 males and 2 females with an average age of 39 years(range,19-72 years).Mean follow-up was 16 months(range.4-18 months).The average time to radiographic union was 4 months(range.3-7 months).Range of motion measurements at final follow-up were obtained in 11 out of 12 patients,with one patient defaulting follow-up.All 11 patients displayed a functional elbow range of motion of at least 30°-130°.with an average arc of motion of 130°(range.110°-140°).mean elbow flexion of 134°(range.110°-140°)and mean flexion contracture of 3°(range.0°-20°).The mean DASH score was 16(range.2.5-43.8)and the mean MEPS was 75(range.65-100).Complications observed included one patient with a superfic ial wound infection which resolved with a course of oral antibiotics and one patient with radiographic evidence of heterotopic ossification which was conservatively managed.No residual elbow instability was observed and no reoperations were performed.Conclusion:Buttress plate fixation via a medial approach of coronoid process fractures that contribute to persistent elbow instability represents a reliable method of treatment that produces satisfactory and predictable outcomes.展开更多
The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery,underscored by its relatively infrequent occurrence and the lack of comprehensive clin...The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery,underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines.This review aims to elucidate the available approaches for TMJ reconstruction,with a particular emphasis on recent groundbreaking advancements.The current spectrum of TMJ reconstruction integrates diverse surgical techniques,such as costochondral grafting,coronoid process grafting,revascularized fibula transfer,transport distraction osteogenesis,and alloplastic TMJ replacement.Despite the available options,a singular,universally accepted‘gold standard’for reconstructive techniques or materials remains elusive in this field.Our review comprehensively summarizes the current available methods of TMJ reconstruction,focusing on both autologous and alloplastic prostheses.It delves into the differences of each surgical technique and outlines the implications of recent technological advances,such as 3D printing,which hold the promise of enhancing surgical precision and patient outcomes.This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ,thereby improving the quality of life for patients with end-stage TMJ disorders.展开更多
文摘BACKGROUND The diagnosis of coronoid process hyperplasia(CPH)is usually based on symptoms and radiological imaging.Because of its similar symptoms,it can be confused with temporomandibular joint diseases.Therefore,an objective and reproducible way of diagnosis should be determined.AIM To investigate CPH using Levandoski analysis on panoramic radiographs to determine its prevalence.METHODS A total of 300 panoramic radiograph images(600 coronoid processes)were examined.Having measured the Condyle-Gonion(Cd-Go)and Coronoid-Gonion(Cor-Go)distances,the Cor-Go:Cd-Go ratio was calculated for the left and right sides of each image.RESULTS There was a statistically significant difference in Cd-Go and Cor-Go distances between male and female participants(P<0.001).There was no statistically significant relationship between Cor-Go:Cd-Go ratios and gender(P>0.05).CONCLUSION Cd-Go and Cor-Go distances were statistically significantly increased in males on both the left and right sides.The ratio of Cor-Go:Cd-Go was preserved in both genders.The prevalence of CPH was found to be 0.3%.
文摘Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures surgically fixed in our institution using a buttress plate technique via a medial approach between June 2012 and April 2015 by the senior author was performed.These fractures were all sizeable fractures contributing to persistent elbow instability in terrible triad or varus posteromedial rotatory instability injury patterns.A prospective telephone questionnaire was conducted to assess patient outcomes using the disabilities of the arm,shoulder and hand(DASH)score and Mayo hlbow performance score(MEPS).Results:Twelve patients were included in the study,comprising 10 males and 2 females with an average age of 39 years(range,19-72 years).Mean follow-up was 16 months(range.4-18 months).The average time to radiographic union was 4 months(range.3-7 months).Range of motion measurements at final follow-up were obtained in 11 out of 12 patients,with one patient defaulting follow-up.All 11 patients displayed a functional elbow range of motion of at least 30°-130°.with an average arc of motion of 130°(range.110°-140°).mean elbow flexion of 134°(range.110°-140°)and mean flexion contracture of 3°(range.0°-20°).The mean DASH score was 16(range.2.5-43.8)and the mean MEPS was 75(range.65-100).Complications observed included one patient with a superfic ial wound infection which resolved with a course of oral antibiotics and one patient with radiographic evidence of heterotopic ossification which was conservatively managed.No residual elbow instability was observed and no reoperations were performed.Conclusion:Buttress plate fixation via a medial approach of coronoid process fractures that contribute to persistent elbow instability represents a reliable method of treatment that produces satisfactory and predictable outcomes.
基金supported by NSFC(82370932)Research and Develop Program of West China Hospital of Stomatology Sichuan University(RD-03-202102,LCYJ2019-20)Natural Science Foundation of Sichuan Province(2023NSFSC1512,2024NSFSC1588)。
文摘The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery,underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines.This review aims to elucidate the available approaches for TMJ reconstruction,with a particular emphasis on recent groundbreaking advancements.The current spectrum of TMJ reconstruction integrates diverse surgical techniques,such as costochondral grafting,coronoid process grafting,revascularized fibula transfer,transport distraction osteogenesis,and alloplastic TMJ replacement.Despite the available options,a singular,universally accepted‘gold standard’for reconstructive techniques or materials remains elusive in this field.Our review comprehensively summarizes the current available methods of TMJ reconstruction,focusing on both autologous and alloplastic prostheses.It delves into the differences of each surgical technique and outlines the implications of recent technological advances,such as 3D printing,which hold the promise of enhancing surgical precision and patient outcomes.This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ,thereby improving the quality of life for patients with end-stage TMJ disorders.
