Comparison of Measurement Methods of Exophthalmos and Its Forensic Significance / 法医学杂志

Objective To compare the differences between Hertel exophthalmometry and CT on exophthalmos measurement,and explore its practical application value in forensic medicine.Methods Fifty-six normal individuals without eye injuries or diseases were selected as the control group.The absolute values of exophthalmos were measured in the standardized CT image workstation.The difference of binocular exophthalmos was compared in normal group.Forty-seven cases with unilateral orbital fracture were divided into injured eye group and normal eye group according to the presence of binocular orbital fractures.The differences of the absolute values of eophthalmos from the same eye and the relative values of eophthalmos between two eyes for same person measured by Hertel exophthalmometry and CT were analyzed.Results There was no statistical difference of exophthalmos between the normal eyes measured by CT method.In the normal eye group,the absolute value of exophthalmos measured by CT method was (16.66±5.41) rm,which was (16.16±4.45)mm when measured by the Hertel exophthalmometry method.There was no statistical difference between two groups (P＞0.05).In the injured eye group,there was statistical difference between the absolute values of exophthalmos measured by two measurement methods (P＜0.05).There was no statistical difference of the relative values of exophthalmos between the injured eyes and the normal eyes by two measurement methods (P＞0.05).Conclusion CT method has a good consistency with Hertel exophthalmometry,which can be applied into the practice of medicolegal expertise.

One-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft for temporomandibular diseases combined with dental-maxillofacial deformities.</p><p><b>METHODS</b>The preoperative measurement and model surgery was performed. The patients underwent arthroscope assisted condylar reconstruction with costochondral graft combined with bimaxillary surgery or mandibular surgery.</p><p><b>RESULTS</b>From Sept. 2003 to Dec. 2005, 15 cases were treated successfully with no bleeding, nerve injury and infection. The patients were followed up for 29 to 52 months (mean, 31.8 months). The appearance was markedly improved. TMJ function was good with no pain. The average maximum interincisal opening was 33.6 mm.</p><p><b>CONCLUSION</b>Compared with traditional operation, one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft has its advantages. Indication selection and preoperative design are very important.</p>

The clinical application of arthroscope-assisted reconstruction of the mandibular condyle with costochondral graft / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This is a preliminary study of the endoscopic technique on open surgery. The purpose of this study is to introduce the use of endoscopic technique for the reconstruction of the condyle with costochondral graft through a preauricular incision.</p><p><b>METHODS</b>33 patients of temporomandibular joint diseases (n=49) underwent reconstruction of mandibular condyle with costochondral graft. After preparation of the recipient site through a preauricular incision, maxillo-mandibular fixation, and preparation of the costochondral graft, the graft was fixed to the lateral side of the mandible ramus under the supervision of arthroscope.</p><p><b>RESULTS</b>All the patients had successful reconstruction of the condyle with costochondral graft without any severe bleeding or craniocerebral injury.</p><p><b>CONCLUSION</b>This case series demonstrates the feasibility of endoscopic technique for the reconstruction of the condyle through a preauricular incision. It has the advantage of high efficiency, minimal postoperative morbidity, great patient comfort, and little appearance impairment. The endoscopic technique has a promising future.</p>

Condylar resorption of unknown reason: diagnosis and treatment / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of condylar resorption of unknown reason.</p><p><b>METHODS</b>The clinical data including the records of history, physical examination, radiography and laboratory of ten patients were studied. Ten patients consisted of 8 females and 2 males (mean age 24.1 years, range 19-31 years) had common clinical features including anterior open bite, posterior occlusal prematurities and Class II malocclusion. Images demonstrated a small and short condyle with abnormal shape, usually accompanied by the developmental insufficiency of the ramus and condyle. The condylar, even the ramus, showed the black marrow signal on MRI images. Four patients were treated by condylar reconstruction with costochondral graft after condylectomy under the supervision of endoscope. Two patients were treated by reduction and repair of disk. Four patients didn't accept any treatment.</p><p><b>RESULTS</b>Four patients treated by condylar reconstruction with costochondral graft showed structures with the size and shape morphologically similar to normal joint and achieved a stable occlusion after follow-up of 6-18 months. Two patients treated by reduction and repair of disk didn't show significant change of open bite and remodeling of condyle after follow-up of 4-6 months.</p><p><b>CONCLUSION</b>The diagnosis of condylar resorption of unknown reason can be achieved based on the physical examination and radiographical images. The condylar reconstruction with costochondral graft after condylectomy is feasible.</p>