髁突骨软骨瘤继发牙颌面畸形的数字化外科治疗

doi:10.13591/j.cnki.kqyx.2026.01.004

口腔医学 ›› 2026, Vol. 46 ›› Issue (1): 20-26.doi: 10.13591/j.cnki.kqyx.2026.01.004

• 口腔遗传病和罕见病的诊治 • 上一篇下一篇

髁突骨软骨瘤继发牙颌面畸形的数字化外科治疗

付昊杰, 曹健, 于洪波, 张雷, 余婧爽(), 王旭东()

上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,中国医学科学院口腔颌面再生医学创新单元,上海(200011)

收稿日期:2025-11-05 出版日期:2026-01-28 发布日期:2026-01-16
通讯作者: 余婧爽,王旭东 E-mail:yjs4213@163.com;xudongwang70@hotmail.com
作者简介:王旭东,教授、主任医师、博士研究生导师,国家重点研发项目首席科学家,国家健康科普专家,上海交通大学医学院附属第九人民医院院长,国家口腔医学中心(上海)副主任,上海交通大学数字医学研究院副院长,上海市儿童颅颌面畸形筛查诊治中心主任与上海市口腔临床质量控制中心主任。现任中华口腔医学会口腔遗传病与罕见病专业委员会主任委员、中华口腔医学会口腔颌面创伤及正颌专业委员会副主任委员、上海市口腔医学会口腔遗传病与罕见病专业委员会主任委员等。研究方向:颅颌面发育与畸形发生机制研究;数字化与人工智能应用颅颌面缺损与畸形诊疗关键技术研发与应用;颅颌面部新型修复材料的研发。近5年主持国家重点研发项目、国家自然科学基金项目等课题20余项,发表SCI论文110余篇。已授权国家专利65项,出版专著11部。荣获上海市东方英才计划领军项目、上海市优秀学科带头人、上海市科技进步奖一等奖(第一完成人)、宝钢优秀教师奖、上海市育才奖等荣誉。
基金资助:
国家重点研发计划(2023YFC2414100);国家自然科学基金(82370905);国家自然科学基金(82071096);上海市口腔-颅颌面数字化技术研发与应用专业服务平台(21DZ2294600);国家临床重点专科建设项目(Z155080000004);上海市重中之重研究中心(2022ZZ01017);上海市促进产业高质量发展专项(2024-GZL-RGZN-02033)

Digital surgical treatment for dental-jaw facial deformities secondary to condylar osteochondroma

FU Haojie, CAO Jian, YU Hongbo, ZHANG Lei, YU Jingshuang(), WANG Xudong()

Department of Oral Craniomaxillofacial, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology & Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China

Received:2025-11-05 Online:2026-01-28 Published:2026-01-16
Contact: YU Jingshuang, WANG Xudong E-mail:yjs4213@163.com;xudongwang70@hotmail.com

摘要/Abstract

摘要：

髁突骨软骨瘤(condylar osteochondroma,OC)是一种罕见的下颌髁突良性肿瘤,常继发偏颌畸形。传统治疗先行开放性肿瘤切除,二期正颌外科矫治牙颌面畸形,面神经损伤风险高、多次手术创伤大。上海交通大学医学院附属第九人民医院通过计算机辅助外科设计、内镜、导航、个性化导板及个性化植入物等数字化技术的应用与探索,实现从术前个性化设计到术中执行的口内入路微创肿瘤切除和同期正颌手术的精准控制,标志着OC治疗从经验外科迈入数据驱动的精准外科新阶段。

关键词: 髁突骨软骨瘤, 数字化外科, 微创外科, 精准外科, 个性化手术设计

Abstract:

Condylar osteochondroma (OC) is a rare benign tumor of the mandibular condyle, often resulting in mandibular deviation or asymmetry. Traditionally, treatment involves a two-stage procedure—open tumor resection followed by orthognathic surgery to correct the associated dentofacial deformities. This approach carries a high risk of facial nerve injury and increased trauma due to multiple surgical interventions. At Shanghai Ninth People’s Hospital, digital technologies—including computer-assisted surgical design, endoscopy, navigation, personalized surgical guides, and customized implants—have been integrated to achieve precise control from preoperative planning to intraoral, minimally invasive tumor resection performed concurrently with orthognathic correction. This paradigm shift marks the transition of OC management from experience-based surgery to data-driven precision surgery.

Key words: condylar osteochondroma, digital surgery, minimally invasive surgery, precision surgery, personalized surgical design

中图分类号:

R782.6

付昊杰, 曹健, 于洪波, 张雷, 余婧爽, 王旭东. 髁突骨软骨瘤继发牙颌面畸形的数字化外科治疗[J]. 口腔医学, 2026, 46(1): 20-26.

FU Haojie, CAO Jian, YU Hongbo, ZHANG Lei, YU Jingshuang, WANG Xudong. Digital surgical treatment for dental-jaw facial deformities secondary to condylar osteochondroma[J]. Stomatology, 2026, 46(1): 20-26.

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参考文献 43

[1]	Ribas MD, Martins WD, de Sousa MH, et al. Osteochondroma of the mandibular condyle: Literature review and report of a case[J]. J Contemp Dent Pract, 2007, 8(4): 52-59.
[2]	Wolford LM, Movahed R, Dhameja A, et al. Low condylectomy and orthognathic surgery to treat mandibular condylar osteochondroma: A retrospective review of 37 cases[J]. J Oral Maxillofac Surg, 2014, 72(9): 1704-1728. doi: 10.1016/j.joms.2014.03.009
[3]	Holmlund AB, Gynther GW, Reinholt FP. Surgical treatment of osteochondroma of the mandibular condyle in the adult. A 5-year follow-up[J]. Int J Oral Maxillofac Surg, 2004, 33(6): 549-553. doi: 10.1016/j.ijom.2004.01.006
[4]	Kwon YE, Choi KS, An CH, et al. Recurrent osteochondroma of the mandibular condyle: A case report[J]. Imaging Sci Dent, 2017, 47(1): 57-62. doi: 10.5624/isd.2017.47.1.57
[5]	Chen MJ, Yang C, Qiu YT, et al. Osteochondroma of the mandibular condyle: A classification system based on computed tomographic appearances[J]. J Craniofac Surg, 2014, 25(5): 1703-1706. doi: 10.1097/SCS.0000000000000898
[6]	刘丽敏, 孙晶晶, 钱佳骏, 等. 171例颌面部骨软骨瘤及恶变病例临床病理分析[J]. 上海口腔医学, 2024, 33(3):324-327.
[7]	Wolford LM, Movahed R, Perez DE. A classification system for conditions causing condylar hyperplasia[J]. J Oral Maxillofac Surg, 2014, 72(3): 567-595. doi: 10.1016/j.joms.2013.09.002
[8]	Poorna TA, Alagarsamy R, Ek J, et al. A systematic review and meta-analysis of the surgical outcomes in patients with osteochondroma of mandibular condyle[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2023, 135(6): 732-745. doi: 10.1016/j.oooo.2022.09.039
[9]	Vezeau PJ, Fridrich KL, Vincent SD. Osteochondroma of the mandibular condyle: Literature review and report of two atypical cases[J]. J Oral Maxillofac Surg, 1995, 53(8): 954-963. doi: 10.1016/0278-2391(95)90293-7
[10]	Wolford LM. Clinical indications for simultaneous TMJ and orthognathic surgery[J]. Cranio, 2007, 25(4): 273-282. pmid: 17983127
[11]	Wolford LM, Mehra P, Franco P. Use of conservative condylect-omy for treatment of osteochondroma of the mandibular condyle[J]. J Oral Maxillofac Surg, 2002, 60(3): 262-268. doi: 10.1053/joms.2002.30570
[12]	Wolford LM, Karras S, Mehra P. Concomitant temporomandibular joint and orthognathic surgery: A preliminary report[J]. J Oral Maxillofac Surg, 2002, 60(4): 356-362;discussion 362-363. doi: 10.1053/joms.2002.31940
[13]	Suarez-Cunqueiro MM, Schon R, Gellrich NC, et al. Endoscopic assistance in the removal of a foreign body in the condylar process[J]. J Craniofac Surg, 2004, 15(1): 98-101. pmid: 14704573
[14]	赵泽亮, 王旭东. 下颌骨髁突骨软骨瘤诊疗进展[J]. 中华口腔医学研究杂志(电子版), 2011, 5(3): 322-327.
[15]	Schön R, Fakler O, Gellrich NC, et al. Five-year experience with the transoral endoscopically assisted treatment of displaced condylar mandible fractures[J]. Plast Reconstr Surg, 2005, 116(1): 44-50. pmid: 15988246
[16]	Xia J, Ip HH, Samman N, et al. Computer-assisted three-dimensional surgical planning and simulation: 3D virtual osteotomy[J]. Int J Oral Maxillofac Surg, 2000, 29(1): 11-17. doi: 10.1016/S0901-5027(00)80116-2
[17]	Liu XJ, Gui L, Mao C, et al. Applying computer techniques in maxillofacial reconstruction using a Fibula flap: A messenger and an evaluation method[J]. J Craniofac Surg, 2009, 20(2): 372-377. doi: 10.1097/SCS.0b013e31819b9443
[18]	Yang XQ, Hu J, Yin GZ, et al. Computer-assisted condylar reconstruction in bilateral ankylosis of the temporomandibular joint using autogenous coronoid process[J]. Br J Oral Maxillofac Surg, 2011, 49(8): 612-617. doi: 10.1016/j.bjoms.2010.10.015 pmid: 21084137
[19]	Yang XQ, Hu J, Zhu SS, et al. Computer-assisted surgical planning and simulation for condylar reconstruction in patients with osteochondroma[J]. Br J Oral Maxillofac Surg, 2011, 49(3): 203-208. doi: 10.1016/j.bjoms.2010.03.004 pmid: 20427106
[20]	Wang XD, Lin YP, Yu HB, et al. Image-guided navigation in optimizing surgical management of craniomaxillofacial fibrous dysplasia[J]. J Craniofac Surg, 2011, 22(5): 1552-1556. doi: 10.1097/SCS.0b013e31822e5d3d pmid: 21959385
[21]	Yu HB, Li B, Zhang L, et al. Computer-assisted surgical planning and intraoperative navigation in the treatment of condylar osteochondroma[J]. Int J Oral Maxillofac Surg, 2015, 44(1): 113-118.
[22]	Si J, Zhang C, Tian M, et al. Intraoral condylectomy with 3D-printed cutting guide versus with surgical navigation: An accuracy and effectiveness comparison[J]. J Clin Med, 2023, 12(11): 3816. doi: 10.3390/jcm12113816
[23]	Lim W, Weng LK, Tin GB. Osteochondroma of the mandibular condyle: Report of two surgical approaches[J]. Ann Maxillofac Surg, 2014, 4(2): 215-219. doi: 10.4103/2231-0746.147151 pmid: 25593879
[24]	Kim HS, Kim JY, Huh JK, et al. A surgical strategy for severe facial asymmetry due to unilateral condylar overgrowth[J]. Int J Oral Maxillofac Surg, 2016, 45(5): 593-600. doi: 10.1016/j.ijom.2015.12.007
[25]	Cao J, Shen SY, Liu ZX, et al. Evaluation of mandibular symmetry in patients with condylar osteochondroma who underwent intro-oral condylar resection and simultaneous bimaxillary orthognathic surgery[J]. J Craniofac Surg, 2020, 31(5): 1390-1394. doi: 10.1097/SCS.0000000000006432 pmid: 32310874
[26]	沈末伦, 余婧爽, 于洪波, 等. 导航及内镜技术联合正颌手术矫治髁突骨软骨瘤伴颌骨畸形数字化流程的建立与应用[J]. 中华口腔医学杂志, 2016, 51(12): 728-733.
[27]	Seki H, Fukuda M, Takahashi T, et al. Condylar osteochondroma with complete hearing loss: Report of a case[J]. J Oral Maxillofac Surg, 2003, 61(1): 131-133.
[28]	Chan BH, Leung YY. SPECT bone scintigraphy for the assessment of condylar growth activity in mandibular asymmetry: Is it accurate[J]. Int J Oral Maxillofac Surg, 2018, 47(4): 470-479. doi: 10.1016/j.ijom.2017.09.008
[29]	赵泽亮, 沈国芳, 石慧敏, 等. 髁突骨软骨瘤与髁突增生患者的CT表现特点分析[J]. 中国口腔颌面外科杂志, 2012, 10(2): 139-145.
[30]	沈末伦, 朱凌, 王旭东. 髁突骨软骨瘤的CT与MRI诊断价值比较[J]. 中国口腔颌面外科杂志, 2017, 15(2): 147-152.
[31]	Avinash KR, Rajagopal KV, Ramakrishnaiah RH, et al. Computed tomographic features of mandibular osteochondroma[J]. Dentomaxillofac Radiol, 2007, 36(7): 434-436. doi: 10.1259/dmfr/54329867
[32]	Zhang J, Wang H, Li X, et al. Osteochondromas of the mandibular condyle: Variance in radiographic appearance on panoramic radiographs[J]. Dentomaxillofac Radiol, 2008, 37(3): 154-160. doi: 10.1259/dmfr/19168643
[33]	Obwegeser HL, Makek MS. Hemimandibular hyperplasia: Hemi-mandibular elongation[J]. J Maxillofac Surg, 1986, 14(4): 183-208. doi: 10.1016/s0301-0503(86)80290-9 pmid: 3461097
[34]	Roychoudhury A, Bhatt K, Yadav R, et al. Review of osteochondroma of mandibular condyle and report of a case series[J]. J Oral Maxillofac Surg, 2011, 69(11): 2815-2823. doi: 10.1016/j.joms.2010.10.016
[35]	Chen MJ, Yang C, Qiu YT, et al. Local resection of the mass to treat the osteochondroma of the mandibular condyle: Indications and different methods with 38-case series[J]. Head Neck, 2014, 36(2): 273-279. doi: 10.1002/hed.v36.2
[36]	Eller DJ, Blakemore JR, Stein M, et al. Transoral resection of a condylar osteochondroma: Report of case[J]. J Oral Surg, 1977, 35(5): 409-413.
[37]	Hernández-Alfaro F, Méndez-Manjón I, Valls-Ontañón A, et al. Minimally invasive intraoral condylectomy: Proof of concept report[J]. Int J Oral Maxillofac Surg, 2016, 45(9): 1108-1114. doi: 10.1016/j.ijom.2016.04.001
[38]	Deng M, Long X, Cheng AA, et al. Modified trans-oral approach for mandibular condylectomy[J]. Int J Oral Maxillofac Surg, 2009, 38(4): 374-377. doi: 10.1016/j.ijom.2009.01.020
[39]	Zhu M, Liu F, Zhou CZ, et al. Does intraoperative navigation improve the accuracy of mandibular angle osteotomy: Comparison between augmented reality navigation, individualised templates and free-hand techniques[J]. J Plast Reconstr Aesthet Surg, 2018, 71(8): 1188-1195. doi: S1748-6815(18)30119-0 pmid: 29729839
[40]	Meng QG, Chen S, Long X, et al. The clinical and radiographic characteristics of condylar osteochondroma[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(1): e66-74.
[41]	Yu HB, Jiao FF, Li B, et al. Endoscope-assisted conservative condylectomy combined with orthognathic surgery in the treatment of mandibular condylar osteochondroma[J]. J Craniofac Surg, 2014, 25(4): 1379-1382. doi: 10.1097/SCS.0000000000000862 pmid: 24905948
[42]	Yu HB, Sun H, Li B, et al. Endoscope-assisted conservative condylectomy in the treatment of condylar osteochondroma through an intraoral approach[J]. Int J Oral Maxillofac Surg, 2013, 42(12): 1582-1586. doi: 10.1016/j.ijom.2013.05.002
[43]	Ellis E. Complications of mandibular condyle fractures[J]. Int J Oral Maxillofac Surg, 1998, 27(4): 255-257. doi: 10.1016/S0901-5027(05)80506-5

髁突骨软骨瘤继发牙颌面畸形的数字化外科治疗

Digital surgical treatment for dental-jaw facial deformities secondary to condylar osteochondroma

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