【摘要】 目的 通过分析单侧颞下颌关节盘复位手术前后咀嚼肌(翼内肌、翼外肌、咬肌)的形态变化，筛选有效评价指标，为手术疗效提供更全面的评估依据。方法 回顾性分析2022年1月至2023年12月94例单侧关节盘前移位患者的MRI资料，包括不可复性移位(ADDwoR,78例)和可复性移位(ADDwR,16例)，测量健侧和患侧翼内肌、翼外肌上头/下头及咬肌的形态学参数，并比较ADDwoR患者手术前后患侧咀嚼肌的变化。结果 ADDwoR患者患侧咬肌体积比(患侧/健侧)为0.79,ADDwR患者咬肌体积比为0.91;术后ADDwoR患者咬肌体积比升至1.00，形态趋近健侧。结论 单侧关节盘不可复性前移位可造成明显咬肌萎缩，术后咬肌对称性改善但未完全恢复。术前术后咬肌对称性变化可作为评估手术疗效、颌面部肌群功能协调与面部美观改善的重要指标。更多还原

【Abstract】 Objective To analyze the morphological changes of masticatory muscles(medial pterygoid,lateral pterygoid,and masseter) before and after unilateral temporomandibular joint disc repositioning surgery,and to identify effective evaluation indicators,thereby providing a more comprehensive basis for assessing surgical efficacy. Methods A retrospective analysis was performed on MRI data from 94 patients with unilateral anterior disc displacement between January 2022 and December 2023,including those with disc displacement without reduction(ADDwoR,n = 78) and with reduction(ADDwR,n = 16). Morphological parameters of the bilateral medial pterygoid muscle,superior/inferior heads of the lateral pterygoid muscle,and masseter muscle were measured. Masticatory changes before and after surgery were analyzed in ADDwoR patients. Results In ADDwoR patients,the affected-side/healthy-side volume ratio of the masseter muscle was 0.79. In ADDwR patients,the masseter volume ratio was 0.91. Postoperatively,the masseter volume ratio in ADDwoR patients increased to 1. 00,with morphology tending to approximate the healthy side. Conclusion Unilateral ADDwoR is manifested with significant masseter atrophy. Postoperative masseter symmetry improves but does not fully recover. Changes in masseter symmetry before and after surgery can serve as an important indicator for evaluating surgical efficacy and reflecting functional and aesthetic improvements in the maxillofacial muscle groups.更多还原