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
Extra-articular ankylosis resulting from bony union between the coronoid process and the zygoma is very rare. It may result from facial fractures caused by gunshots, treated or untreated facial fractures or may arise ...Extra-articular ankylosis resulting from bony union between the coronoid process and the zygoma is very rare. It may result from facial fractures caused by gunshots, treated or untreated facial fractures or may arise as an extension of intracapsular ankylosis. We report a case of ankylosis between the coronoid process and the zygomatic arch in a 33-year-old Black male. The bony ankylosis was the result of a 2 year old untreated zygomatic arch fracture. Ankylosis developed secondary to heterotopic bone formation following trauma. The patient was treated by intra-oral coronoidectomy, followed by physiotherapy for three months. He returned for review one year later with a mouth-opening of 40 mm and a stable occlusion.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
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
Background:Mass fatality incidents occur due to environmental,medical,vehicle,industrial,or terrorist events that can involve large numbers of victims.Identification of these victims is of utmost importance in these s...Background:Mass fatality incidents occur due to environmental,medical,vehicle,industrial,or terrorist events that can involve large numbers of victims.Identification of these victims is of utmost importance in these situations.Cone-beam computed tomography(CBCT)may be helpful in some forensic contexts,offering several advantages for postmortem forensic imaging.Aim:The research study aims to evaluate the sexual dimorphism of the maxillary sinus and inter coronoid distance to estimate sex by using CBCT.Materials and Methods:In 40 CBCT scans of 20 males and 20 females,maxillary sinuses height,width and inter coronoid distances of mandible were measured for forensic analysis.In high quality,reconstructed images ofbilateral maxillary sinuses,height,and width were measured,and in mandible,inter coronoid was measured in axial view.Results were tabulated and analyzed using an unpaired r-test and discriminant function analysis used to compare difierences in the measured parameters between males and females.Results:Mean values of inter coronoid in males and females are(♂=88.1,♀=78.1).The maxillary sinus right side height and width(♂=32.2,♀=24.6)(♂=19.7,♀=19.6)left side height and width(♂=32.7,♀=23.6)(♂=18.1,♀=17.8),respectively.A statistically significant(P<0.05)difference was found in maxillary sinus and inter coronoid distance between males and females.Results showed significantly larger dimensions of maxillary sinus and inter coronoid distance in males compared to females.The correct predictive accuracy rate of sex detennination was 100% in females and 90% in males with overall accuracy of 95%.Conclusion:The present study showed the importance of maxillary sinus dimensions and inter coronoid distance in sex estimation using cone-beam computed tomography in forensic medicine.展开更多
[目的]介绍"肘关节恐怖三联征"的概念(肘关节后脱位同时伴有桡骨头和尺骨冠突骨折),并报告5例患者的临床治疗体会。[方法]自2004年4月～2007年3月,作者共收治肘关节三联征损伤5例。桡骨头骨折按Mason法分类:Ⅱ型4例,Ⅲ型1例;...[目的]介绍"肘关节恐怖三联征"的概念(肘关节后脱位同时伴有桡骨头和尺骨冠突骨折),并报告5例患者的临床治疗体会。[方法]自2004年4月～2007年3月,作者共收治肘关节三联征损伤5例。桡骨头骨折按Mason法分类:Ⅱ型4例,Ⅲ型1例;按Schatzker法分类:Ⅰ型1例,Ⅱ型3例,Ⅲ型1例。尺骨冠突骨折按Regan-Morrey法分类:Ⅰ型1例,Ⅱ型4例;按O′Driscoll法分类:5例均为Ⅰ型。4例采取了手术内固定治疗,以3 mm钛空心拉力螺钉或1 mm K针分别固定冠突和桡骨头,并缝合修复肘内外侧副韧带。术后屈肘90°前臂旋转中立位石膏外固定3周,开始屈伸和旋转康复训练。[结果]4例手术治疗的患者经3个月～3年随访,骨折愈合,肘关节稳定,无疼痛。肘关节屈伸幅度平均120°,前臂旋转幅度平均110°。3例随访1年以上,Mayo肘关节功能评分:优2例,良1例。未手术治疗的1例功能评定为差,有肘关节不稳定和疼痛。[结论]肘关节恐怖三联征的骨折片虽然很小,但伴有肘内外侧副韧带撕裂,肘关节严重不稳定。只有在重建了骨关节和软组织结构稳定的基础上,及早(3周内)进行康复锻炼,才能获得较好的功能恢复。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Extra-articular ankylosis resulting from bony union between the coronoid process and the zygoma is very rare. It may result from facial fractures caused by gunshots, treated or untreated facial fractures or may arise as an extension of intracapsular ankylosis. We report a case of ankylosis between the coronoid process and the zygomatic arch in a 33-year-old Black male. The bony ankylosis was the result of a 2 year old untreated zygomatic arch fracture. Ankylosis developed secondary to heterotopic bone formation following trauma. The patient was treated by intra-oral coronoidectomy, followed by physiotherapy for three months. He returned for review one year later with a mouth-opening of 40 mm and a stable occlusion.
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.
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.
文摘Background:Mass fatality incidents occur due to environmental,medical,vehicle,industrial,or terrorist events that can involve large numbers of victims.Identification of these victims is of utmost importance in these situations.Cone-beam computed tomography(CBCT)may be helpful in some forensic contexts,offering several advantages for postmortem forensic imaging.Aim:The research study aims to evaluate the sexual dimorphism of the maxillary sinus and inter coronoid distance to estimate sex by using CBCT.Materials and Methods:In 40 CBCT scans of 20 males and 20 females,maxillary sinuses height,width and inter coronoid distances of mandible were measured for forensic analysis.In high quality,reconstructed images ofbilateral maxillary sinuses,height,and width were measured,and in mandible,inter coronoid was measured in axial view.Results were tabulated and analyzed using an unpaired r-test and discriminant function analysis used to compare difierences in the measured parameters between males and females.Results:Mean values of inter coronoid in males and females are(♂=88.1,♀=78.1).The maxillary sinus right side height and width(♂=32.2,♀=24.6)(♂=19.7,♀=19.6)left side height and width(♂=32.7,♀=23.6)(♂=18.1,♀=17.8),respectively.A statistically significant(P<0.05)difference was found in maxillary sinus and inter coronoid distance between males and females.Results showed significantly larger dimensions of maxillary sinus and inter coronoid distance in males compared to females.The correct predictive accuracy rate of sex detennination was 100% in females and 90% in males with overall accuracy of 95%.Conclusion:The present study showed the importance of maxillary sinus dimensions and inter coronoid distance in sex estimation using cone-beam computed tomography in forensic medicine.
文摘[目的]介绍"肘关节恐怖三联征"的概念(肘关节后脱位同时伴有桡骨头和尺骨冠突骨折),并报告5例患者的临床治疗体会。[方法]自2004年4月～2007年3月,作者共收治肘关节三联征损伤5例。桡骨头骨折按Mason法分类:Ⅱ型4例,Ⅲ型1例;按Schatzker法分类:Ⅰ型1例,Ⅱ型3例,Ⅲ型1例。尺骨冠突骨折按Regan-Morrey法分类:Ⅰ型1例,Ⅱ型4例;按O′Driscoll法分类:5例均为Ⅰ型。4例采取了手术内固定治疗,以3 mm钛空心拉力螺钉或1 mm K针分别固定冠突和桡骨头,并缝合修复肘内外侧副韧带。术后屈肘90°前臂旋转中立位石膏外固定3周,开始屈伸和旋转康复训练。[结果]4例手术治疗的患者经3个月～3年随访,骨折愈合,肘关节稳定,无疼痛。肘关节屈伸幅度平均120°,前臂旋转幅度平均110°。3例随访1年以上,Mayo肘关节功能评分:优2例,良1例。未手术治疗的1例功能评定为差,有肘关节不稳定和疼痛。[结论]肘关节恐怖三联征的骨折片虽然很小,但伴有肘内外侧副韧带撕裂,肘关节严重不稳定。只有在重建了骨关节和软组织结构稳定的基础上,及早(3周内)进行康复锻炼,才能获得较好的功能恢复。
