中文摘要：

目的：探讨颞下颌关节（TMJ）盘锚固术中游离脂肪组织瓣移植预防黏连的效果。方法：选取3个月龄小型猪6只．将左侧作为实验组．对其进行关节盘前附着松解，并切取耳前区脂肪瓣．移植到松解后的间隙内。右侧作为对照组．只进行关节盘前附着松解。术前，术后3、6个月分别测其最大被动开口度，术后3、6个月各处死3只动物，取关节标本．分别进行HE染色和Masson染色．观察有无黏连形成。采用SPSS16．0软件包对测量数据进行Wilcoxon符号秩和检验。结果：与术前相比，小型猪的最大被动开口度在术后3个月、6个月逐步减少，差异显著（P〈0．01）。开口型不同程度地偏向右侧。HE染色显示．实验侧关节表面光滑．无黏连形成；对照侧关节术后3个月滑膜表面充血明显，有细小的黏连形成：术后6个月可见致密的纤维结缔组织。Masson染色显示，对照侧黏连组织中可见致密的胶原及弹力纤维．其内偶见小血管。结论：在TMJ盘锚固术中，游离脂肪瓣能较好地预防纤维黏连形成，值得推广应用。

英文摘要：

PURPOSE： To observe the effect of free fat flap grafts on prevention of adhesion after temporomandibular joint （TMJ） disc anchorage. METHODS： Six three-month-old minipigs were included in our study. Maximal passive mouth opening was measured before operation. The left joints were as experimental sides. The anterior attachment was released and free fat flap from the front of ear lobe was grafted in the gap. The right joints were as control group with release of the anterior attachment alone. Maximal passive mouth opening was measured 3 and 6 months after operation and then the joint tissues were excised for histological study to observe the formation of adhesion. Maximal passive mouth openings were analyzed with SPSS 16.0 software package for Wileoxon signed rank test. RESULTS： Maximal passive mouth openings were reduced gradually 3 months and 6 months after operation. There were significant differences between the 3 groups （/9〈0.01）. The mandible of all minipigs deviated to the right side. HE staining showed that the surface of experimental joint was smooth while there was adhesion formation in the control joint. Masson staining showed that blue dense fibers were present in the control group. CONCLUSION： Free fat flap grafts in the TMJ operation can prevent adhesion formation. Supported by Natural Science Foundation of Shanghai Municipality （10ZR1418200）, Shanghai Pujiang Talent Plan in 2011, 2013 National Natural Science Foundation of China（81371168）, Research Fund of Science and Technology Committee of Shanghai Municipality （13XD1402300） and the Seventh Students Innovative Training Project of Shanghai Jiao Ttong University School of Medicine（2013052）.