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经翼点入路或前颅窝手术时常需将颞肌分离到颧骨以下直达颞窝。由于手术损伤、暴露、电凝等使肌纤维损伤而术后达不到肌重建,缺损部位的瘢痕形成导致颞肌弹性和伸展性下降,日后产生张口困难。作者报道11例因硬膜外血肿、颅底脑膜瘤、动脉瘤而经颞部手术后导致最大张口度受限的病人,年龄21～59岁,男性7例,女性4例。这些病人颞部均有疤痕覆盖,张口范围从3～21mm 不等(正常为35～60mm),强迫张口时则颞部感到不适,而下颌关节的X 平片正常,提示张口困难是颞肌疤痕挛缩所致。对于此类患者可进行理疗或手术治疗,早期发现者理疗有明显效果;晚期(>6个月)发现者困疤痕已经形成,理疗无效,可采用手术治疗,手术方法为颞肌分离或加冠状突切除术,术后可获永久性治愈。作者在讨论中指出,经翼点入
Pterional approach or anterior cranial fossa surgery often need to be separated from the temporal muscles below the cheekbone direct access to the temporal fossa. Due to surgical injury, exposure, coagulation and other muscle fiber damage and postoperative muscle rebuild less than the defect site of the scars resulting in decreased temporal muscle elasticity and extensibility, resulting in future mouth opening difficulties. The authors report 11 patients aged 21- 59 years old, 7 males and 4 females due to epidural hematomas, skull base meningiomas and aneurysms that underwent maxillofacial surgery after temporal surgery. These patients have scars covering the temporal, mouth range from 3 ~ 21mm range (normal 35 ~ 60mm), force the mouth when the temporal discomfort, and the mandibular X-ray film is normal, suggesting that the mouth is difficult to open muscle scars Contracture caused. For such patients can be physical therapy or surgical treatment, early discoverer physical therapy had a significant effect; late (> 6 months) discoverer scar has been formed, physical therapy invalid, surgical treatment can be used, the method of operation for the temporal muscle or crown Prominent surgery, postoperative permanent cure. The author pointed out in the discussion that after the introduction of the wing