经缝牵引成骨早期矫正儿童面中份发育不全  

Trans-sutural distraction osteogenesis for early correction of midfacial hypoplasia in children: a primary clinical report

作　　者：柳春明[1] 黄旭明[1] 侯敏[1] 梁立民[1] 马骁[1] 张海钟[1] 高全文[1] 宋儒耀[2] 

机构地区：[1]解放军总医院军医进修学院,北京100853 [2]中国医学科学院整形外科医院

出　　处：《中华整形外科杂志》2005年第2期90-93,共4页Chinese Journal of Plastic Surgery

摘　　要：目的　临床探索经缝牵引、均衡前移面中份骨骼 ,早期矫治面中份发育不全的新技术新方法。方法　选择 6～ 12岁面中份发育不全的患儿 ,采用弹性外牵引装置矫正面中份发育不全。牵引系统由经鼻孔插入的骨承力牵引装置、面弓和牙科正畸用的橡皮圈组成。全麻下于梨状孔外下缘的外侧钻孔 ,通于下鼻道的前部 ;或在硬腭的前部钻孔 ,穿透鼻底。经鼻孔将骨牵引承力装置插入梨状孔缘或鼻底的骨孔内。手术后第 1～ 2天用连接于面弓和骨牵引装置的正畸橡皮圈进行牵引。牵引力为 6 0 0～ 12 0 0g ,随骨骼移动的进度不断调整。骨骼移动达到预定的位置后 ,减小牵引力维持牵引。结果　临床治疗 9例患儿。面中份骨骼移动均衡。患者面容和咬合关系完全恢复正常。面部侧面观显示上、中、下各部分协调匀称 ,眶下、颧部和上唇部丰满 ,鼻背挺拔。结论　中位缝牵引技术能够早期有效地矫正面中份畸形 ,骨骼前移均衡 ,且方法简便 。Objective To probe the possibility of trans-sutural distraction osteogenesis for correction of children midfacial hypoplasia. Methods The trans-sutural distraction system of mid-facial skeleton consisted of the bone-borne traction hooks of titanium, the face-bow, and the elastic loops. Nine children with midfacial hypoplasia were treated at their 6～12 years of age. No osteotomy was made in them. Bone holes were drilled with a dental bur at each side of the lateral-inferior rim of the aperture, or at the anterior part of the hard palate. The traction device was hitched to the holes through the nostrils. Protraction began 3 days postoperatively, with the forces adjusted dependently upon the rate of progress. When the skeleton reached to the planed position, it was retained with a minor force for 8 weeks. Results The mid-facial skeleton of the nine children showed a balanced advancement. Their facial profile and cross-bite were corrected satisfactory. Conclusions Patients with severe mid-facial hypoplasia could be corrected ideally by the new technique, with minor trauma, easy manipulation. The design of protraction system was reasonable.;

关 键 词：经缝牵引 早期矫正 儿童 面中份发育不全 Ⅲ类错颌 

分 类 号：R726.2[医药卫生—儿科]