Cheek bone. Nzira yepanguva ye zygomatic bone

Chimwe chezvikamu zvepamusoro zvechiso chechiso chedehenya ndiye malar bone. Inoumba zygomatic arch, iyo ndiyo muganhu we fovea wetemberi.

Zvikamu zvegadziriro

Dama bone ari chikwata chinonzi quadrangular. Iyo inobata chikamu (visceral) chikamu chedehenya rine chikamu cheropi. Mukuwedzera, iyo inobatanidza maxillary bone necheka-yakafanana, yenguva uye yepfupa bone. Zvose izvi zvinomutsigira zvakasimba.

Ikoko kune nzvimbo nhatu, iyo malar bone inogadzirwa. Anatomy inoparadzanisa zvinyorwa (lateral), zvenguva uye zvisingabatsiri.

Yokutanga yeiyi convex. Iyo yakabatana nemapfupa e-maxillary, epamberi uye nguva dzemulobes nekubatsira kwetatu nzira. Chikamu chemafuta chinobatanidzwa mukugadzirwa kwebato re lateral rekufamba uye chikamu chepasi. Chikamu chenguva pfupi chinobatanidzwa mukuumbwa kwe pedicle fossa, uye ndege yayo inodzoka shure.

Pasi peyo malar bone

Chikamu chemafuta chinotapira, chinobatanidzwa mukugadzirwa kwepakati penhengo dzomumativi, iyo ndiyo chikamu chesvingo rwokunze nechomukati. Kubva panze, ichi chinopinda mulobo-chinangwa chekutanga, uye pamberi payo chinonzi infraorbital chinogadziriswa. Inogadzirisawo cheki chaiyo-eye orifice. Icho chando chebhuruki chepamberi chekutanga chinosvika pakakwirira.

Nzvimbo yepakati iri mukati uye kumashure. Zvinotora chikamu pakuumbwa kwerusvingo rwomukati rwe fovea rwetemberi. Pamusoro pake pane cheek-uye-temporal rinotanga. Nzira yemazuva e zygomatic bone, iyo inowedzera kubva pakatarisana kwayo, yakabatanidzwa ne zygomatic tsanangudzo yemazuva epfupa. Pamwe chete vanoumba zygomatic arch. Pakati pavo ndiyo inonzi temporo-zygomatic suture.

Imwe nzvimbo yakasara yepfupa ndiyo zygomatic. Iyo inotapira, inotenderera, ine chibhakera chakakosha uye kutarisa-chiso chekuzarura. Yaro yepamusoro yepakati yemuganhu ndiyo muganhu wepamukova wekutenderera kubva kumativi uye kubva pasi. Lobnovoobnovoj otrostok (inofungidzirwa kuti iyo chikamu chayo) is nizhnnenaruzhny nzvimbo yenzvimbo yakataurwa. Pamberi payo, yakawedzerwa kupfuura kupfuura kumashure. Iyo fossa yepamberi pfupa yakabatana nayo. Pakati pavo ndiyo maxillary maxillary suture. Inowanikwa pamucheto wokumusoro wechitatu wepamusoro wezvinyorwa, inonzi frontal.

Uyewo zygomatic bone yakaiswa pamwe chete nemapapiro makuru emapfupa, anonzi wedge-akafanana bone. Kubatana kwavo kunoumba wedge-zygomatic suture.

Zviratidzo

Pamusana pehukuru hwechimwe chinhu chinodikanwa chegunha chemaziso, chimiro chayo nemakumbo, ayo akaumbwa nemapapiro epamberi, tsanangura rudzi rwekuvaka, hutano, rudzi, makore.

Nyanzvi dzinotsvaga matanho maviri ekusimbiswa kwe zygoma: inogadzirisa mishonga uye bone. Zvinotarisa kuti zvikamu zve 2-3 zvekushambadzira zvinowanikwa mumutambo wekutanga wekuita pamuviri. Vatove mumwedzi wechitatu wekuvandudza intrauterine.

Izvo zvinonakidzawo kuti kuburikidza nechikamu chebasa chepfupa nerubatsiro rwepurojekiti shoma iwe unogona kupinda mumugwagwa unoputika mumapfupa e-cheek-temporal uye mabhulo-maziso.

Kukuvara kunogona kuitika

Kana zvichikuvara kumeso, kuputsika kwemalar bone hakugoni kubudiswa kunze. Inoratidzirwa ne deformation uye kumadokero kwedunhu rinowirirana. Muchifukidzo chiri pasi uye munzvimbo ye zygomatic arch munhu anogona kuona iyo inonzi stair. Muchiitiko ichi, kune matambudziko apo uchiedza kushamisa muromo wako kana kuita kuti mushure mutsva uri pasi. Uyewo, kuputika kunofambidzana nehemorrhages mu retina yeziso uye kurasikirwa kwekunzwisisa, kupera munharaunda yeropa re infraorbital.

Kana zygomatic bone yave yakasununguka zvakanyanya, saka kunogona kuve nekubuda ropa kubva kune rumwe rutivi kune rumwe rutivi uye kuonekwa kusakanganisika, izvo varwere vanotsanangura sekushenesa kwezvinhu. Asi zvinongogoneka kuita kuti uongororwe mushure mokuongorora X-ray.

Nzira dzokurapa

Kana chokwadi chekuputsika kwemalar mafu chakasimbiswa mumufananidzo, zvinoreva kuti zvakakosha kudzorera kutendeseka kwayo. Izvi zvinoitwa nekushandura kusvibiswa panzvimbo yakakodzera. Mushure meizvi, zvinodikanwa kuzvigadzirisa. Kudai pakanga pasina hurumende, ipapo kurapwa kunongogadziriswa nehutachiona hwehutano uye kusarudzwa kwe physiotherapy nzira.

Surgical repair

Kushanda kupindira kunodiwa chete mumatambudziko akasiyana. Izvi zvinosanganisira mamiriro ayo malar bone ehenya ave aputswa, uye maitiro ayo akadzingwa.

Kupindira kwose kunogona kugoverwa kuva intraoral uye extraoral. Nzira dzeRimberg, Gillies, Dingman dzinonyatsozivikanwa. Zvinoreva nzira dzokuwedzera.

Mune zvimwe zviitiko, kuvimbika kwayo kunogona kudzorerwa kuburikidza nekucheka mumuromo. Kana zygomatic bone yakagadzirirwa ne titanium mini-mahwendefa, izvi zvinopa migumisiro yakanyanyisa.

Mushure mokunge uine chero mhando dzemhando dzekupindira, zvakakosha kudzivisa kusvibiswa kushanduka kwemapfupa emapfupa. Kuti uite izvi, rega kuvhara muromo, shandisa mvura yakasviba uye yakanyorova, usarara pane zvakakanganisika ziso.

Tsanangudzo yezvenzira dzakasiyana

Nzira yeLimberg ndeyokuti hokore imwe-dzino inowedzerwa mukati mechipfuva kuburikidza nechigadziro chakakosha (dzimwe nguva, kunyange zvakadaro, zvishoma zvishoma zvinokonzerwa nemupumburu zvinogadzirwa) mumucheto wezasi we zygomatic arch. Kuvimbika kwepfupa kunodzorerwa nekufambisa, kunoitwa nenzira yakatarisana nekusimuka. Kana ichienzaniswa uye yakagadzirirwa panzvimbo yakakodzera, chimiro chekuita chinonzwika. Muchiitiko ichi, kuenzanisa kwechiso kunodzorerwa. Uyewo inonyangarika chikamu chakanga chiri mumucheto wakadzika we-orbit.

Kuti udzorere kutenderera kwepamusoro uye kuisa hurongwa hwemangwana hwemalapa panzvimbo, nzira yeGillies inogona kushandiswa. Chiremba anoshanda anocheka mucheka. Mukuita kudaro, inodzinga ganda, zviduku zvinoshandiswa uye zvisikwa zvemazuva. Kupfurikidza nekishamba iyo refu inounzwa ku zygomatic arch kana bone, gauze swab inoiswa pasi payo. Zvadaro, nechinzvimbo chakakosha, icho chinoshandiswa sevhiri, chikamu chinowanikwa munzvimbo yakakodzera.

Maererano nenzira yeDingman, a rektare anoiswa mu inframammary fossa kuburikidza ne 1.5 cm refu incision. Kuputika kunoitwa munharaunda yenguva yakasara yetshisi. Muchiitiko ichi, mushure mokudzorera kutenderera kwepamusoro pemafupa, munyori wechirongwa akakurudzira kuti firati yakagadziriswa ishandiswe munharaunda yepamucheto wakadzika we-orbit uko iyo yakatarisana nayo malar bone iripo.

Intraoral methods

Kana zvakakosha kubvisa zvimedu zvakasununguka zvakasimudza mapfupa, ropa ravha, zvikamu zvemukati, pane dzimwe nzira dzekupindira kwakagadzirwa. Izvi zvinogoneka chete kana uchiita mabasa ehurumende, pasi payo iyo sinilla maxillary inoshandiswa inoitwa.

Kudzorera kuvimbika kwemapfupa, kudurwa kunoitwa munharaunda yepakati remukati rehutano. Muchiitiko ichi, chengetedza periosteal-mucous flap. Izvi zvinoitwa nerubatsiro rweTractor kana mabhandi eNotalsky, ayo anoitwa pasi pemaitiro emutambo we malar bone.

Mukuita basa iri, zvinogonawo kugadzirisa zvidimbu zvepasi yezvigadziko zveziso. Nokuda kwechikonzero ichi, tampon ye iodoform inoiswa munharaunda yakakodzera. Anofanira kuchizadza zvakasimba kuitira kuchengetedza mapfupa emapfupa kwemazuva 10 kusvika 14 munzvimbo yakakodzera. Kuguma kwekambani yakaratidzwa kunoratidzwa munharaunda yezasi. Kuti vaite izvi, vanoisa suture.

Kugadzirisa ndege yemapfupa munzvimbo yakakodzera inogona kuve nekubatsirwa kwetitanium mini-mahwendefa kana sefeteri yakagadzirwa munzvimbo inotangira nzira, kumucheto kwakadzika we-orbit, chitubu chinonzi cheek-alveolar. Asi nzira yekutanga inofunga kuti yakavimbika.

Special cases

Mune mamwe mamiriro ezvinhu zvakakosha kushandisa implants. Izvo zvinoshandiswa kuti zvive zvakashata mumapfupa emapfupa. Kakawanda, vanachiremba vanokurudzira mune zviitiko zvakakosha kushandisa makiramu emakeramic, zvichienderana nehydroxyapatite, pamwe neatanium plates.

Nezviratidzo zvakakodzera, kudzvinyirira kwehutachiona hwehutachiona hunogona kuitwa. Izvi zvinoitwa nekusunungura chikamu chemukati uye kuchichiendesa mumugumo. Kuti abvise mapfupa emapfupa emvura yakabva kune dzimwe nyika, zvipembenene zvinogadzirwa zve titanium nickelide zvinogona kushandiswa. Izvi zvinoda kudzorerwa kwepine epithelial yezvivi zvemhino nemapapiro kubva padama kana kubatanidzwa kubva mumuti. Maitiro akadaro anogona kuderedza njodzi yekuwedzera maxillary sinusitis, iyo inogona kukura mushure mekukuvara.

Uchishandisa zvigadzirwa zvekunze, unogona kugadzirisa zygomatic arch. Nokuda kweizvi, ndiro yakagadzirwa nemapurasitiki akaomeswa yakaomeswa. Pasi payo, nguva dzose isa iodine gauze. Inobatsira kudzivirira bhedha maronda.