Itekisi ithambo. Inkqubo yesikhashana ye bone zygomatic

Enye yezinto ezibiniweyo zecala ebusweni bekhayi i-malar bone. Yenza i-zygomatic arch, engumda we-fovea yetempileni.

Iimpawu zesakhiwo

Ihlathi lesithambo liyi-quadrangular element element. Ubambe inxalenye ebusweni (i-visceral) yeckull kunye nesebe layo lobuchopho. Ukongezelela, idibanisa ithambo elingu-maxillary elinothambo olumile, olusesikhatsini kunye nolusemva. Konke oku kudala inkxaso yakhe eqinileyo.

Kukho indawo emithathu, apho i-malar bone ihlanganiswe. I-Anatomy ikwahlula i-buccal (lateral), i-temporal and orbit.

Iyokuqala kwezi zinto zidityaniswa. Ixhunyiwe kuma-maxillary amathambo, i-lobes yangaphambili kunye ne-temporal ngoncedo lweenkqubo ezintathu. Inxalenye ye-glabular ithatha inxaxheba ekwakheni udonga olusemva lwe-orbit kunye nenxalenye yalo. Icandelo lexeshana lithatha inxaxheba ekwakheni i-pedicle fossa, kwaye inqwelo yalo iyajika.

Umphezulu we-malar bone

Icandelo elibhakabhaka lihamba kakuhle, lithatha inxaxheba ekubunjweni kweendawo zangaphandle ze-orbit, oko kukuthi inxalenye yodonga lwaso lwangaphandle kunye nxalenye engezantsi. Ukusuka ngaphandle, lo mgangatho udlulela kwinkqubo ye-lobo-siseko, kwaye phambi kwayo umda we-infraorbital uvalelwe. Kwakhona kwindlu ekhethekileyo itekisi. Ubuso obunamaqabunga obumgangatho obanzi buqulethe ukuphakama okuphawulwe kakuhle.

Ubuso besikhashana ngaphakathi nangaphakathi. Kuthatha inxaxheba ekwakheni udonga oluphambili lwe-fovea yetempile. Kulo kutyhulwa kwehlathini kunye nesikhashana. Inkqubo yesikhashana yethambo le-zygomatic, elivela kwi-angle yangaphambili, lixhomekeke kwinkqubo ye-zygomatic yethambo lexeshana. Bonke benza i-zygomatic arch. Phakathi kwabo yinto ebizwa ngokuba yi-temporo-zygomatic suture.

Enye indawo esecaleni kwitheko i-zygomatic. I-smooth, convex, ne-tubercle ekhethekileyo kunye nokuvula ubuso. Umda walo wesigxina esiphezulu ngumda wesango lokungena kwi-ecaleni kunye nangaphezulu. Lobnovoobnovoj otrostok (ithathwa njengengxenye yayo) yi-nizhnnenaruzhny indawo yomhlaba ochaziweyo. Ngaphambi kwayo, ikhuliswe ngaphezu kweyasemva. I-fossa yethambo langaphambili lidibene nayo. Phakathi kwabo yinto ephezulu yama-maxillary suture. Itholakala kumgca ongaphantsi komgca wesithathu we-appendix, ebizwa ngokuba yimphambili.

Kwakhona ithambo le-zygomatic linamathele kunye nephiko elikhulu lesithambo, elibizwa ngokuthi ithambo elinjenge-wedge. Ukuxhamla kwabo kwakha i-wedge-zygomatic suture.

Izixhobo

Ngenxa yobukhulu bale nxalenye ethile yesikhala sobuso, ukuma kwayo kunye nama-angles, ayenziwa kunye neendawo zangaphambili, ukuchonga uhlobo lokwakha, isini, ubuhlanga, iminyaka.

Iingcali ziqaphela amanqanaba amabakala okuphuhliswa kwe-zygoma: izicubu ezixhamlayo kunye namathambo. Kuyaphawuleka ukuba iindawo ezi-2-3 ze-ossification zivela kwi-trimester yokuqala yokukhulelwa. Sekunjalo kwinyanga yesithathu yokuphuhliswa kwe-intrauterine.

Kwakhona kuyaphawuleka ukuba ngokusebenzisa inxalenye engabonakaliyo ithambo ngoncedo lwesondlo esincinci ungayifumana umsele ongena emathanjeni emathunzini esitek-temporal and cheek-face.

Ukulimala okunokwenzeka

Xa kunobungozi ebusweni, ukuphulwa kwethambo le-malar alikwazi ukukhishwa. Kubonakaliswe ukuguqulwa kunye nentshonalanga yommandla ohambelanayo. Kwinqanaba le-eyelidi elingaphantsi kunye nommandla we-zygomatic omnye unokubona okubizwa ngokuba yi-stair. Kule meko, kukho iingxaki xa uzama ukuvula umlomo wakho okanye wenze ukunyakaza kwe-lateral yomhlathi osezantsi. Kwakhona, iziqhekeza zihamba kunye ne-retina ye-retina yeso kunye nokulahlekelwa ngumzwelo, ukuphazamiseka kummandla wentsholongwane ye-infraorbital.

Ukuba ithambo le-zygomatic liye lafuduswa ngokufudumele, ngoko ke kunokuba negazi eliphuma kummandla kwicala elifanayo kunye nokukhubazeka okubonakalayo, apho izigulane zichaza njengokuhlenga kwezinto. Kodwa kunokwenzeka ukuba kwenziwe ukuxilongwa emva kokuhlolwa kwe-X-ray.

Izindlela zokonyango

Ukuba inkohlakalo ye-malar bone yaqinisekiswa emfanekisweni, kuthetha ukuba kubalulekile ukubuyisela ukuthembeka kwayo. Oku kwenziwa ngokuguqula i-wreckage kwindawo efanelekileyo. Emva koko, kunqweneleka ukukulungisa. Ukuba kwakungabikho ukufuduka, ngoko unyango luphelelweyo kwonyango lonyango kunye nokuqeshwa kwamanyathelo e-physiotherapy.

Ukulungiswa kokupanda

Ukungenelela kokusebenza kuyadingeka kuphela kwiimeko eziqhelekileyo. Ezi ziquka iimeko apho i-malar bone yeckull iphuliwe, kwaye iinkqubo zayo ziyafuduswa.

Zonke iindlela zokungenelela ezinokungenwa ziyakwazi ukwahlula zibe yi-intraoral and extraoral. Iindlela zeLimberg, iGillies, iDingman ziyazi kakuhle. Bhekisela kwiindlela zokuncedisa.

Kwezinye iimeko, ingqibelelo yayo ingabuyiselwa ngokunqunyulwa kwisigidi somlomo. Ukuba ithambo le-zygomatic lichanekile kunye neetanium-plates, le nto inika iziphumo ezintle.

Emva kokufezekisa naziphi na iindidi zongenelelo, kubalulekile ukukhusela ukufuduka kwimihlaba yeethambo. Ukwenza oku, thintela ukunyakaza komlomo, udle ukutya okunomsoco kunye noluthambileyo, ungalali kwicala elonakalisiweyo lobuso.

Inkcazo yeendlela zokungcebeleka

Indlela yeLimberg kukuba i-hook yezinyo enye ifakwe kwisigxina ngokugqithiswa okhethekileyo (ngamanye amaxesha, nangona kunjalo, ukukhankanywa kwamacandelo amancinci kwenziwe ngezantsi) kumgca wezantsi we-zygomatic arch. Ubungqina bethambo bubuyiselwa ngokunyakaza, okwenziwe kwicandelo elingaphambene nokufuduka. Xa kuthelekiswa kwaye isetyenziswe kwindawo echanekileyo, ucofa oluphawulekayo. Kule meko, ukulinganisa ubuso bubuyiselwe. Kwakhona iyaphela inyathelo elisezantsi lomjikelezo.

Ukuze ubuyisele ingqibelelo yomhlaba kwaye ufake inkqubo yesikhashana yesikhumba se-malar endaweni, indlela yaseGillies ingasetyenziswa. Ugqirha osebenzayo wenza umgca. Ngokwenza njalo, ikhupha isikhumba, izicubu ezincinci kunye ne-fascia yesikhashana. Ngokusebenzisa isixhobo sokuphakamisa i-elevator ifakwe kwisitye okanye ithambo le-zygomatic, i-swab swab ifakwe phantsi kwayo. Emva koko, nge sixhobo esikhethekileyo, esetyenziswe njengenqindi, le fragment isetyenziswe kwindawo echanekileyo.

Ngokuya kwindlela yokuDingman, umbuyiseli ufakwa kwi-inframammary fossa ngokusebenzisa i-1.5 cm long incision. Ukutshatyalaliswa kwenzelwe kwingingqi yecandelo le-lateral ye-eyebrow. Kule meko, emva kokubuyisela ubungqina bomhlaba wesithambo, umbhali wecandelo lincoma ukusebenzisa i-suture kummandla we-edge edge ye-orbit apho i-frontal process of the malar bone.

Iindlela zokuziphatha

Ukuba kuyimfuneko ukususa amaqhekeza amathambo angamahhala, ama-blood clots, iinxalenye ze-membrane ye-mucous, ke ezinye iindlela zokungenelela ngophuhliso ziphuhliswa. Oku kunokwenzeka kuphela xa kuqhutywe imisebenzi ye-intraoral, phantsi kwayo i-sinus maxillary.

Ukubuyisela ukuthembeka kwamathambo, isinqununu senziwe kwingingqi yenkqubo yenguqu ye- alveolar. Kule meko, shenxisa i-flao-periosteal-mucous flap. Oku kwenziwa ngosizo lwe-Retractor okanye iBlades of Buyalsky, ezenziwa phantsi kwexesha lexesha le-malar bone.

Ekufezeni le ntsebenzo, kunokwenzeka ukuba ukulungiswa kweziqhekeza ezantsi kweziseko zeso. Ngenxa yale njongo, i-iodoform tampon ifakwe kwisininzi esifanelekileyo. Kumele azalise ngokuqinileyo ukwenzela ukuba agcine amathambo esithuba seentsuku eziyi-10-14 kwindawo echanekileyo. Ukuphela kwesitampu esibonisiwe kuboniswe kwinqanaba elisezantsi. Ukwenza oku, bawutyunde.

Ukulungisa ilanga lesithambo kwindawo echanekileyo kunokwenzeka ngoncedo lweetanium mini-plates okanye umgca wocingo esetyenziswe kwingingqi yenkqubo yangaphambili, umgca ophantsi we-orbit, i-crest ibizwa ngokuba ngumhlathi. Kodwa indlela yokuqala ibhekwa ngokuthembekileyo.

Iimeko ezizodwa

Kwezinye iimeko kukho imfuneko yokusebenzisa implants. Zibekwe iiphene kwiithambo zethambo. Ngokuqhelekileyo, oogqirha bancomela kwiimeko ezikhethekileyo ukuba basebenzise izimplantshi ze-ceramic, ngokusekelwe kwi-hydroxyapatite, kunye kunye neetati zeetanium.

Ngeendlela ezifanelekileyo, ukugqithiswa kwe-nervorital nervous can be done. Oku kwenziwa ngokukhulula inxalenye yayo kwaye uyishukumisela ukuba ihambe. Ukuphelisa iziphene zethambo le-alveolar ridge, izilwanyana ezenziwe nge-titanium nickelide zingasetyenziswa. Oku kufuna ukubuyiselwa kwebhanti ye-epithelial yeimpazamo zempumlo kunye ne-flaps ehlathini okanye ukuxhoma kwi-palate. Iindlela ezinjalo zinokunciphisa umngcipheko wokuphuhlisa i-sinillasi e-maxillary, enokukhula emva kokulimala.

Ukusebenzisa ii-seams zangaphandle, unako ukulungisa i-zygomatic arch. Kule nto, isitya esenziwe ngeplastiki ekhuni ngokukhawuleza sisetyenziswe kuso. Ngaphantsi kwayo, soloko ubeka i gauze ye-iodine. Kunceda ukuphepha izilonda zokulala.