口腔颌面外科学PDF电子书下载

第一章　绪论INTRODUCTION 1

一、口腔颌面外科的定义和内容Definition and contents of oral and maxillofacial surgery 1

二、我国口腔颌面外科简史Briefhistory of oral and maxillofacial surgery in China 2

三、我国口腔颌面外科的发展及特点Development and characteristics of oral and maxillofacial surgery in China 4

四、口腔颌面外科和相关学科的关系Relationship between oral and maxillofacial surgery and related disciplines 5

五、口腔颌面外科发展展望Development trends of oral and maxillofacial surgery 5

第二章　口腔颌面外科临床检查与基本操作THE CLINICAL EXAMINATIONS AND BASIC SURGICAL TECHNIQUES OF ORAL AND MAXILL OF ACIAL SURGERY 8

第一节 口腔颌面外科临床检查Clinical examinations of oral and maxillofacial surgery 8

一、一般检查General examinations 8

二、辅助检查Auxiliary examinations 15

第二节 消毒和灭菌Disinfections and sterilization 19

一、手术室与手术器材的消毒灭菌Disinfections and sterilization of the operation room and surgical armamentarium 20

二、手术者的消毒Disinfections of surgical team 21

三、手术区的消毒灭菌Disinfections and sterilization of surgical area 21

第三节 手术基本操作Basic techniques of operations 25

一、显露Exposure of surgical field 25

二、止血Hemostasis 26

三、解剖分离Dissection 28

四、打结Surgical knot 28

五、缝合Suture 30

六、引流Drainage 36

第四节 创口的处理Treatment of surgical wound 38

一、创口愈合的过程Healing of surgical wound 38

二、临床创口分类Clinical classification of surgical wounds 39

三、各类创口的处理原则Principles of treating different kinds of wound 39

四、换药的基本原则Basic principles of dressing change 40

五、换药的注意事项Precautions of dressing change 40

六、绷带应用技术Application of bandage 40

第三章　麻醉学ANESTHESIOLOGY 45

第一节 局部麻醉Local anesthesia 45

一、局部麻醉药Local anesthetics 46

二、局部麻醉的方法Methods of local anesthesia 49

三、局部麻醉的并发症Complications of local anesthesia 60

第二节　全身麻醉General anesthesia 63

一、口腔颌面外科全身麻醉的特殊性Characteristics of general anesthesia for oral and maxillofacial surgery 63

二、全身麻醉方法Methods of general anesthesia 65

三、ASA分级ASA physical status 67

四、麻醉并发症及处理Anesthetic complications and management 67

五、心脏骤停和心肺复苏Cardial arrest and cardiopulmonary resuscitation（CPR） 68

六、困难气管内插管Difficult endotracheal intubation 71

第三节　疼痛与镇痛Pain and analgesia 72

一、疼痛的定义和分类Definition and classification of pain 73

二、疼痛过程Pain process 73

三、疼痛的测量方法Pain measurement 78

四、疼痛的临床特征Clinical features of pain 79

五、疼痛的治疗Paintherapy 81

第四章　牙及牙槽外科DENTAL AND ALVEOLAR SURGERY 85

第一节 牙拔除术Extraction of tooth 85

一、概述Principles of tooth extraction 85

二、术前评估Preoperative evaluation 86

三、术前准备Preparation 90

四、拔牙器械和用法Instruments for extraction of tooth 91

五、拔牙基本步骤Basic procedures for extraction 96

六、各类牙的拔出法特点Specific techniques for removal of each tooth 97

七、牙根拔除术Root extraction 100

八、拔牙创的愈合Normal healing of extraction wounds 105

九、并发症Complications 106

第二节 阻生牙拔除术Removal of impacted teeth 113

一、下颌阻生第三磨牙拔除术Removal of impacted mandibular thired molar 114

二、上颌阻生第三磨牙拔除术Removal of impacted maxillary thired molar 122

三、上颌阻生尖牙拔除术Removal of impacted maxillary canine 124

第三节 牙再植与牙移植Replantation and transplantation of teeth 125

一、牙再植Replantation of teeth 125

二、牙移植Transplantation of teeth 127

第四节 牙槽突外科Alveolar surgery 128

一、修复前外科Preprosthetic surgery 128

二、其他牙槽外科手术Other operations in alveolar surgery 133

第五章　口腔种植外科ORAL IMPLANT SURGERY 137

第一节 简要历史背景History and background 137

第二节 骨结合与其生物学基础Osseointegration and its biological fundamentals 139

第三节 当代口腔种植系统的分类Classifications of dental implant system 142

一、根形种植体及其分类Root form implant and classification 142

二、种植体设计的趋势Trend of implant design 145

三、种植系统的选择Selection of implant system 145

第四节 口腔种植治疗的准备与计划Pre-operative preparation and treatment planning 146

一、基本条件Essentials of dental implant 146

二、病人的选择Selection of patients 146

三、检查与诊断Examination and diagnosis 147

四、研究模型Model analysis 148

五、X线检查与排除X线放大率Radiological examination and exclusion of the magnification 148

六、种植体的位置与轴向Position and axis of implant 149

七、外科引导颌板Surgical guide plate 149

八、多牙缺失的治疗设计Implant planning in multi-teeth missing 149

九、其他特殊考虑Some special considerations 150

第五节 种植外科基本手术Principles of implant surgery 151

一、基本原则Basic principles 151

二、外科切口Surgical incision 151

三、逐级备洞Graded drilling 152

四、植入种植体Placement of implant 152

五、关闭伤口Wound closure 152

六、种植Ⅱ期手术Second stage operation 152

第六节 颌骨不同区域的种植外科技术Implant placement in different area of jaws 153

一、下颌无牙颌种植Implant placement in edentulous jaws 153

二、下颌后牙区种植术Implant placement in posterior mandible 154

三、上颌前牙区单牙位种植Single implant placement in front maxilla 154

四、前牙多牙缺失的种植修复Multi-implant placements in front maxilla 156

五、上颌后牙区种植术Implant placement in posterior maxilla 157

第七节 种植外科的并发症Complications of implant surgery 157

一、出血Hemorrhage 158

二、神经损伤Nerve injury 158

三、上颌窦黏膜穿孔Perforation of sinus membrane 158

四、邻牙损伤Adjacent teeth injury 158

五、颌骨骨折Mandible fracture 158

六、器械误吞Swallow of instrument 158

七、软组织裂开Dehiscence 159

八、术后血肿Hematoma 159

九、术后感染Infection 159

十、种植体松动Implant lossening 159

第六章 口腔颌面部感染INFECTIONS OF ORAL AND MAXILLOFACIAL REGIONS 163

第一节 概论Conspectus 163

一、口腔颌面部感染的特点Characteristics of infections in oral and maxillofacial regions 164

第二节 抗菌药物在抗感染中的应用Application of antibiotics in treatment of infections of oral and maxillofacial regions 170

一、抗菌药物的作用机制Mechanism of antibacterial 170

二、药物敏感试验及其临床价值Drug sensitivity test and its clinical value 171

三、抗菌药物的耐药性Drug resistance of antibiotics 172

四、抗菌药物的不良反应及防治Adverse reactions of antibiotics and its management 172

五、抗菌药物的合理应用Application of antibiotics 175

六、常用抗菌药物Common antibiotics 178

第三节 智牙冠周炎Pericoronitis 183

第四节 面颈部淋巴结炎Faciocervical lymphnoditis 185

第五节 面部疖痈Furuncle and carbuncle of face 187

第六节 口腔颌面部间隙感染Oral and maxillofacial space infection 190

一、眶下间隙感染Infraorbital space infection 190

二、颊间隙感染Buccal space infection 191

三、颞间隙感染Temporal space infection 193

四、颞下间隙感染Infratemporal space infection 194

五、咬肌间隙感染Masseteric space infection 195

六、翼下颌间隙感染Pterygomandibular space infection 196

七、舌下间隙感染Sublingual space infection 197

八、咽旁间隙感染Parapharyngeal space infection 198

九、下颌下间隙感染Submandibular space infection 199

十、颏下间隙感染Submental space infection 200

十一、口底多间隙感染Cellulitis of floor of mouth 201

第七节 颌骨骨髓炎Osteomyelitis of jaws 203

一、化脓性颌骨骨髓炎Suppurative osteomyelitis of jaws 203

二、新生儿颌骨骨髓炎Infantile osteomyelitis of jaw 211

三、放射性颌骨坏死（骨髓炎）Osteoradionecrosis of jaws 212

第八节 口腔颌面部特异性感染Specific infection in oral and maxillofacial regions 214

一、颌面骨结核Tuberculosis of facial and jaw bones 214

二、颌面部放线菌病Actinomycosis of maxillofacial region 215

三、颌面部梅毒Syphilis of maxillofacial region 216

第七章　口腔颌面部创伤ORALAND MAXILLOFACIAL TRAUMA 220

第一节 概论Conspectus 220

一、口腔颌面部创伤的流行病学趋势Epidemiologic tendency of oral and maxillofacial trauma 220

二、口腔颌面部创伤的分类Classification of oral and maxillofacial trauma 221

三、创伤评分Trauma scoring 222

四、口腔颌面部创伤的特点Features of oral and maxillofacial trauma 223

五、颌面部交通事故伤Maxillofacial traffic injuries 224

第二节 伤情判断与急救Initial assessment of injury and emergency management 225

一、院前急救与伤员运送Prehospital urgent care and transfer of patients 226

二、伤情判断与复苏Primary assessment of injury severity and resuscitation 226

三、合并颅脑损伤的处理Management of craniocerebral injury 233

四、合并颈椎损伤的处理Management of cervical spine injury 234

五、合并胸腹、四肢损伤的处理Management of chest,abdomen and extremity injury 235

第三节 软组织损伤的清创与早期修复Debridement and primary repair of soft tissue injury 235

一、软组织开放性损伤的清创术Debridement of soft tissue open injury 236

二、软组织损伤的分类处理Surgical treatment of soft tissue injury 236

三、特殊结构损伤的处理Special consideration of management for unique structure injury 238

四、颌面部异物的摘除Removal of foreign body 240

第四节 牙及牙槽突损伤Dental and alveolar injury 242

一、牙折断Tooth fracture 243

二、牙脱位Tooth dislocation 244

三、牙槽突骨折Alveolar fracture 244

第五节 颌面部骨折的诊断与治疗Diagnosis and treatment of maxillofacial fractures 246

一、诊断Diagnosis 246

二、治疗原则Principles of treatment 249

三、骨折复位Reduction of fractures 249

四、骨折固定Fixation of fractures 250

五、骨折愈合Fracture healing 254

第六节 下颌骨骨折Mandibular fracture 255

一、临床分类Clinical classification 255

二、临床表现Clinical presentation 256

三、骨折治疗Treatment of fractures 258

四、陈旧性骨折的治疗Treatment of old fractures 264

第七节 面中部骨折Midfacial fractures 266

一、上颌骨骨折Maxillary fracture 266

二、颧骨、颧弓骨折Zygoma and zygomatic arch fracture 268

三、眼眶骨折Orbital fracture 272

四、鼻眶筛区骨折Naso-orbital-ethmoid fracture 273

第八节 口腔颌面部战伤Oral and maxillofacial war injuries 276

一、火器伤Firearm wound 276

二、核武器伤Nuclear wound 279

三、化学武器伤Chemical weapon wound 280

四、烧伤Burn wound 280

第八章 口腔颌面部肿瘤TUMORS OF ORAL AND MAXILLOFACIAL REGIONS 285

第一节 概论Conspectus 285

一、临床流行病学Clinical epidemiology 285

二、病因Etiology 287

三、口腔颌面部肿瘤的临床表现Clinical manifestations of oral and maxillofacial tumors 290

四、口腔颌面部肿瘤的诊断Diagnosis of oral and maxillofacial tumors 291

五、口腔颌面部肿瘤的治疗Treatment of oral and maxillofacial tumor 295

六、口腔颌面部肿瘤的预防Prevention of oral and maxillofacial tumors 314

第二节 口腔颌面部囊肿Cysts of oral and maxillofacial regions 316

一、软组织囊肿Cysts of soft tissues 316

二、颌骨囊肿Cysts of the jaws 319

第三节 良性肿瘤和瘤样病变Benign tumors and tumor-like lesions 323

一、色素斑痣Nevi 323

二、牙龈瘤Epulis 324

三、纤维瘤Fibroma 325

四、牙源性肿瘤Odontogenic tumors 326

五、血管瘤与血管畸形Hemangioma and vascular malformations 330

六、淋巴管瘤Lymphangioma 332

七、神经源性肿瘤Neurogenic tumors 333

八、颈动脉体瘤Carotid body tumor 334

九、嗜酸性粒细胞增生性淋巴肉芽肿Eosinophilic hyperplastic lymphogranuloma 335

十、骨源性肿瘤及瘤样病变Osteogenic tumors and tumor-like lesions 336

第四节 恶性肿瘤Malignat tumors 339

一、唇癌Carcinoma of the lip 339

二、舌癌Carcinoma of the tongue 339

三、牙龈癌Carcinoma of the gingiva 340

四、口底癌Carcinoma of the floor of mouth 341

五、颊黏膜癌Carcinoma of the buccal mucosa 342

六、腭癌Carcinoma of the palate 342

七、口咽癌Carcinoma of the oropharynx 343

八、面部皮肤癌Carcinoma of the facial skin 344

九、上颌窦癌Carcinoma of the maxillary sinus 344

十、中央性颌骨癌Central carcinoma of the jaws 345

十一、骨源性肉瘤Osteogenic sarcoma 346

十二、颌骨转移性肿瘤Metastatic tumors of the jaws 347

十三、恶性淋巴瘤Malignant lymphoma 347

十四、恶性黑色素瘤Malignant melanoma 349

十五、浆细胞肉瘤Plasma cell sarcoma 350

十六、恶性肉芽肿Malignant granuloma 350

第五节 原发灶不明的颈部淋巴结转移癌Metastatic carcinoma to cervical lymph nodes from unknown primary sites 351

第六节 头颈部多原发癌Multiple primary carcinomas in head and neck 352

第九章 唾液腺疾病DISEASES OF THE SALIVARY GLANDS 356

第一节 唾液腺炎症Sialadenitis 356

一、急性化脓性腮腺炎Acute suppurative parotitis 357

二、慢性复发性腮腺炎Chronic recurrent parotitis 360

三、慢性阻塞性腮腺炎Chronic obstructive parotitis 361

四、涎石病和下颌下腺炎Sialolithiasis and sialadenitis of submandibular gland 362

五、唾液腺特异性感染Special infection of salivary glands 366

第二节 唾液腺损伤和涎瘘Trauma of salivary glands and salivary fistula 368

第三节 舍格伦综合征Sj？gren's syndrome 371

第四节 唾液腺瘤样病变Tumor-like lesions of salivary glands 375

一、唾液腺黏液囊肿Mucocele 376

二、腮腺囊肿Parotid cyst 378

三、唾液腺良性肥大Sialadenosis 379

第五节 唾液腺肿瘤Salivary gland tumors 380

一、诊治原则Principles of diagnosis and treatment 381

二、多形性腺瘤Pleomorphic adenoma 387

三、沃辛瘤Warthin's tumor 387

四、黏液表皮样癌Mucoepidermoid carcinoma 388

五、腺样囊性癌Adenoid cystic carcinoma 388

第十章　颞下颌关节疾病TEMPOROMANDIBULAR JOINT DISEASES 393

第一节 颞下颌关节疾病的分类Classification of the temporomandibular joint diseases 393

第二节 颞下颌关节紊乱病Temporomandibular disorders 395

第三节 颞下颌关节脱位Dislocation of the temporomandibular joint 407

一、急性前脱位Acute forward dislocation 408

二、复发性脱位Recurrent dislocation 410

三、陈旧性脱位Old dislocation 410

第四节 颞下颌关节强直Ankylosis of the temporomandibular joint 411

一、关节内强直Intracapsular ankylosis 411

二、关节外强直Extracapsular ankylosis 414

三、混合性强直Mixed ankylosis 416

第五节 阻塞性睡眠呼吸暂停综合征Obstructive sleep apnea syndrome 417

第十一章　口腔颌面部神经疾患NEURAL DISEASES OF ORAL AND MAXILLOFACIAL REGIONS 430

第一节 三叉神经痛Trigeminal neuralgia 430

一、经典性三叉神经痛Primary trigeminal neuralgia 431

二、症状性三叉神经痛Symptomatic trigeminal neuralgia 445

第二节 舌咽神经痛Glossopharyngeal neuralgia 446

一、经典性舌咽神经痛Primary glossopharyngeal neuralgia 446

二、症状性舌咽神经痛Symptomatic glossopharyngeal neuralgia 448

第三节 面神经疾患Diseases of facial nerve 449

一、创伤性面神经损伤Traumatic facial nerve injury 450

二、贝尔麻痹Bell's palsy 457

三、面肌痉挛Facial spasm 460

第十二章　先天性唇腭裂和面裂CONGENITAL CLEFT LIP/PALATE AND FACIAL CLEFT 464

第一节 发病因素及流行病学Epidemiology and etiology 464

一、唇腭裂与遗传Genetics of cleft lip and palate 464

二、唇腭裂与环境危险因素Environmental risk factors and cleft lip and palate 465

三、唇腭裂与营养Maternal nutrition of cleft lip and palate 465

四、唇腭裂的流行病学Epidemiology of cleft lip and palate 465

第二节 唇腭裂的胚胎学发生和分类Embryology and classification of cleft lip and palate 467

一、原始腭的形成与唇裂的发生Formation of the primary palate and cleft lip 467

二、腭的形成与腭裂的发生Palatogenesis and cleft palate 467

三、唇腭裂的分类Classification of cleft lip and palate 469

第三节 唇裂Cleft lip 472

一、唇裂的病理解剖Anatomy of cleft lip 472

二、唇裂手术的术前准备及术后护理Pre-operation and post-operation care for cleft lip patients 474

三、唇裂手术的基本方法Basic techniques of cleft lip repairing 475

四、唇裂术后继发畸形Secondary deformity 479

第四节 其他面裂Other facial clefts 481

一、面裂的分类Classification of facial cleft 481

二、几种常见的面裂畸形及修复Deformity of facial cleft and surgical correction 482

三、面裂的修复原则Principles of facial cleft repairing 483

第五节 腭裂Cleft palate 484

一、正常腭部的解剖生理Anatomy and physiology of palate 484

二、腭裂腭部的解剖生理Anatomy and physiology of cleft palate 486

三、腭裂修复术的术前准备及术后护理Preoperation prepare and postoperation care for cleft palate surgery 488

四、腭裂手术的基本方法Procedures of cleft palate operation 489

五、腭裂术后并发症及处理Complications of cleft palate operation and management 491

第六节 唇腭裂的牙槽嵴植骨Alveolar bone grafting for cleft lip and palate deformity 493

一、唇腭裂的牙槽嵴裂畸形及牙槽突植骨的目的Aim of alveolar bone grafting on cleft lip and palate deformity 493

二、牙槽嵴裂植骨术的适应证及术前准备Indications of alveolar bone grafting and preoperation prepare 496

三、牙槽嵴裂植骨的手术操作Operation procedures of alveolar bone grafting 496

四、牙槽嵴裂植骨术的术后护理及术后并发症Complications and postoperation care of alveolar bone grafting 498

五、牙槽突植骨术后的效果评价Outcome evaluation 499

第七节 腭咽闭合和腭裂术后腭咽闭合不全Velopharyngeal closure and velopharyngeal incompetence after cleft palate repairing 501

一、腭咽腔的解剖与生理功能Anatomy and physiology of velopharynx cavity 501

二、咽部肌肉Pharyngeal muscles 502

三、发音时腭咽闭合功能的评价Evaluation of velopharyngeal function during speaking 503

四、腭裂术后腭咽闭合不全的治疗Management of velopharyngeal incompetence 504

第八节 腭裂语音的特点及语音治疗Cleft palate speech and speech therapy 508

一、发音器官Organs of articulation 508

二、普通话特点Features of putonghua 509

三、腭裂畸形的语音特点Features of cleft palate speech 511

四、腭裂的语音治疗Speech therapy for cleft palate speech 512

第九节 与唇腭裂有关的综合征Syndromes related with cleft lip and palate 514

一、Pierre Robin序列征Pierre Robin sequence 514

二、腭-心-面综合征Velo-cardio-facial syndrome 515

三、唇腭裂-下唇旁正中瘘Van derWoude syndrome 515

四、遗传性关节-眼病Stickler syndrome 516

第十节 唇腭裂序列治疗Multidisciplinary treatment for cleft lip and palate 518

一、唇腭裂治疗组专家组成和作用Members ofcleft lip and palate team and function 518

二、唇腭裂序列治疗的内容Concept of multidisciplinary treatment for cleft lip and palate 519

三、唇腭裂治疗的时间序列及原则Principle and time table for multidisciplinany treatment 520

第十三章 牙颌面畸形ORAL AND MAXILLOFACIAL DEFORMITIES 522

第一节 病因与临床分类Pathogenesis and clinical classification 522

一、病因Pathogenesis 523

二、临床分类Clinical classification 524

第二节 临床检查与诊断Clinical examination and diagnosis 526

一、临床检查Physical examination 526

二、X线头影测量分析Cephalometric analysis 529

第三节 矫治方案设计Design of surgical corrective procedures 538

一、矫治方案设计的基本原则Basic principle of treatment 538

二、术前、后的正畸治疗Preoperative and postoperative orthodontic therapy 538

三、正颌外科术前面型预测分析Preoperative prediction of facial form 538

四、模型外科Model surgery 540

第四节 正颌外科常用的手术方法Common surgical prccedures of orthognathic surgery 542

一、上颌LeFort I型截骨术Le Fort I osteotomy 543

二、下颌升支矢状劈开截骨术Sagittal split ramus osteotomy（SSRO） 546

三、口内进路水平截骨颏成形术Intraoral horizontal osteotomy genioplasty 548

第十四章 颌骨牵引成骨技术DISTRACTION OSTEOGENESIS FOR JAWS 552

第一节 概述General introduction 552

一、简要发展历史Brief development history 552

二、牵引成骨的基本原理Basic principles of distraction osteogenesis 554

第二节 颌骨牵引成骨的临床应用Clinical application of disfraction osteogenesis for jaws 555

一、颌骨牵引器Distraction devices for jaws 555

二、颌骨牵引成骨的临床分期Clinical staging of distraction osteogenesis for jaws 558

三、颌骨牵引成骨的适应证Indications of distraction osteogenesis for jaws 558

四、患者的选择Select of patients 561

五、操作程序及方法Operative procedures and methods 564

六、颌骨牵引成骨的并发症及其对下牙槽神经及颞下颌关节的影响Complications of distraction osteogenesis for jaws and the influnence on mandibular alveolar nerve and teaporomandibular joint 565

七、展望Prospect 565

第十五章 口腔颌面部获得性缺损与重建ACQUIRED DEFECT AND RECONSTRUCTION IN ORAL AND MAXILLOFACIAL REGION 568

第一节 概论Generality 568

一、致畸因素Etiology 568

二、诊断与治疗Diagnosis and treatment 569

第二节 组织移植Tissue transplantation 570

一、皮肤移植Skin graft 570

二、真皮及脂肪移植Dermis-fat transplantation 574

三、黏膜移植Mucosa transplantation 574

四、皮瓣移植Flap transplantation 575

五、肌肉瓣和肌皮瓣移植Muscular and myocutaneous flap transplantations 578

六、复合移植Composite transplantation 584

七、骨移植Bone graft 584

八、软骨移植Cartilage transplantation graft 586

九、神经移植Nerve transplantation 587

十、组织扩张器Tissue expander 587

第三节 显微外科Microsurgery 589

一、显微外科的基本原则Basic principles of microsurgery 590

二、显微神经外科Microneurosurgery 590

三、口腔颌面部常用的游离组织瓣Common free flaps used in oral and maxillofacial regions 591

第四节 各类畸形和缺损的修复Correction of different malformations and defects 602

一、口角歪斜Distortion of commissure 603

二、小口畸形Microstomia 603

三、唇外翻或内卷Lip ectropion or inuersion 604

四、唇红缺损Defect of vermilion 605

五、面颊部皮肤缺损Faciobuccal skin defect 606

六、鼻畸形及缺损Nasal malformations and defect 607

七、耳、眼睑及其他缺损与畸形Malformations and defects of ear、eyelid and other structures 609

八、颊黏膜缺损的修复Reconstruction of buccal mucosa defect 613

九、舌缺损的修复Reconstruction of lingual defect 613

十、口底缺损的修复Restoration of defect of floor of mouth 614

十一、软腭缺损的修复Restoration of soft palate defect 614

十二、下颌骨缺损的修复Reconstruction of mandibular defect 615

十三、上颌骨缺损的修复Reconstruction of maxillary defect 616