上颌面中颌面骨折解剖形态综述upper-mid-face.ppt

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1、UniversalNeuro21.2mmUpper-FaceModule1.2mm上面部模块1.7mmMid-FaceModule1.7mm面中部模块UniversalMandible下颌通用套件Mini-PlatingSystem迷你接骨板系列UniversalNeuro2系列Mini-PlatingSystem迷你接骨板系列UpperFace/MidFace上面部/面中部Midface面中部TheMidfaceiscomprisedprimarilybyTwoBones:面中部主要包括两块骨骼：TheMaxilla&theZygo

2、ma上颌骨和颧骨Maxillaryfracturesaccountforapproximately10%to20%ofallfacialfractures在所有面部骨折中上颌骨骨折的发生率约为10%-20%。Buttresses支柱效应Supportpillarsofthefaceandtheytransmitforcestothebaseoftheskull.像柱子一样支撑面部并将压力传导到头盖骨底部。Reconstructionofthesebuttressesisthekeytomaxillary/midfacialrepair

3、(andthegeneralprincipleofplateosteosynthesis)在上颌骨/面中部骨折的修复中重建这些支柱非常关键（这也是颌面修复接骨板应用的普遍原则）。Buttresses支柱效应Vertical垂直的Pterygomaxillary(posterior)翼突上颌（后面）Zygomatico-maxillary(lateral)颧骨上颌（侧面）Nasomaxillary(medial)鼻上颌（中间）Horizontal水平的Nasofrontal(supraorbitalrims)鼻骨额骨（眼眶上缘）Naso

4、maxillary(inferiororbitalrims)鼻上颌（眼眶下壁）Inferiorborderofmandible下颌骨下缘HorizontalVertical水平的垂直的FrontalBone额骨NasalBones鼻骨Ethmoid筛骨LacrimalBone泪骨Zygoma颧骨Maxilla上颌骨AlveolarProcess牙槽突Craniomaxillofacial(CMF)Trauma颅颌面（CFM）外伤Directexposureandfixationofthesebuttressesprovidesanat

5、omicalrestoration.直接暴露并固定这些支柱有助于解剖结构的恢复。Maingoalistorestore:修复的主要目标：Height高度Width宽度Projection投影SurgicalExposureSelection术野选择Cosmeticappearance,inconspicuousarea对外表影响较小的不明显的区域。Avoidwhenpossiblemusclesandnerves尽量避开肌肉及神经。Sensorynervesandcranialnerves感觉神经及颅神经Alsoconsideruni

6、queanatomyofpatient还要考虑到患者解剖结构的特殊性。Utilizeopenwoundsforexposuretofracturesite利用开放的伤口暴露出骨折的位置。Exposureofthemaxilla:暴露上颌骨Intraoral:vestibularincision/Sublabial/Gingivobuccalsulcus口内入路：前庭切口/唇下/牙槽沟Periorbital:眶周入路Subciliary睫下Transconjunctival经结膜Subtarsal跗骨下Infraorbital眶下Lat

7、eralbrow眉弓外侧Coronal冠状UpperEyelid/Blephoroplasty上睑/内眼角Zygoma:颧骨：GilliesGillies入路Coronal冠状Lateralbrow眉弓外侧Blepharoplasty眼睑成形术Naso-orbital-ethmoidal:鼻-眶-筛bicoronalincision双侧冠状切口Upper/MidFaceSurgicalApproaches上面部/面中部手术入路CoronalApproach冠状入路Toaccess:Zygomaticarch,Superior,medi

8、al&lateralorbitalrims,NasoethmoidalRegion,andFrontalSinus可进入：颧弓、眼眶前部、中间及后部、鼻筛区及额陡CoronalApproach冠状入路Pericraniu