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患者男性,52岁。以左面部肿物发现10年余于10—10—26入院。於10年前无明显诱因发现左面部生长肿物。初起如乒乓球大,逐渐长至鹅卵大。检查:一般情况好。左侧腮腺咬肌区下颌升枝部肿物约6.0cm×4.0cm,隆起。触之界不清。固定。局部皮色正常。皮温不高。触痛不明显,全颌曲面断层片示左下颌骨升枝部均匀密度减低区约7.0cm×4.0cm。界限清。上界在髁状突下方,下界在下颌角内侧,其后缘骨质较对侧明显变窄。喙状突消炎。髁状突变小。血像正常。初步诊断:下颌骨囊肿。治疗:予以局麻下行囊肿切除,截骨植骨,钛钢颞颌关节置换术。术中见下颌角至髁状突下方隆起,表现骨质已薄如纸。切开骨质,见肿物囊性,下极在8内侧,上极至髁状突下。完整剥出肿物。所余升枝部后缘骨质薄如卵壳,喙突消失,髁状突明显变小。下颌角处骨质尚厚。遂於下颌角处截骨,连同髁状突一并切除。切取右侧第8肋骨10cm,量取相应长度,将
Male patient, 52 years old. To the left side of the tumor was found in more than 10-10-26 10 hospital admission. Ten years ago, no obvious incentive to find the growth of the left side of the tumor. Beginning as a big pingpong, and gradually grow to large goose eggs. Check: Generally good. Left parotid masseter area mandibular lumps of tumor about 6.0cm × 4.0cm, uplift. Touch the world unclear. fixed. Local skin color is normal. Leather temperature is not high. Not obvious tenderness, the whole jaw curved surface of the left mandibular lumps showed a uniform density reduction zone about 7.0cm × 4.0cm. Clear boundaries. The upper bound is below the condyle, the lower bound is inside the mandibular angle, and the posterior border is significantly narrower than the contralateral side. Beak sudden anti-inflammatory. Small condyle mutations. Normal blood. Initial diagnosis: mandibular cyst. Treatment: to local anesthesia cyst removal, osteotomy bone, titanium steel temporomandibular joint replacement. Surgery, see the mandibular angle to the condyle raised below the performance of bone has been thin as paper. Cut the bone, see the cystic mass, the lower pole in the medial 8, the extreme to the condylar process. Complete stripping of the tumor. The remainder of the posterior limb bone as thin as egg shell, coracoid disappear, condyles was significantly smaller. Mandible angle is thick bone. Then osteotomy at the mandibular angle, together with condyle resection. Cut the right side of the 8th rib 10cm, take the appropriate length, will