下颌角嚼肌肥大畸形的口内入路手术矫治  

Intraoral approach for the correction of prominent mandibular angle with masseter muscle hypertrophy

作　　者：李自力[1] 王兴[1] 张熙恩[1] 伊彪[1] 梁成[1] 王晓霞[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,北京100081

出　　处：《中华医学美学美容杂志》2005年第2期65-68,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的　探讨采用口内入路的不同术式矫正下颌角嚼肌肥大畸形的优缺点及适应证。方法　采取口内入路手术共矫治123例,男20例,女103例。基本术式:Ⅰ.嚼肌成形术;Ⅱ.下颌角三角形去骨术;Ⅲ.改良下颌角矢状劈开去骨术。手术组合:单纯Ⅰ,4例;单纯Ⅱ,16 例;Ⅰ+Ⅱ,56 例;单纯Ⅲ,19例;Ⅲ+Ⅰ,9例;Ⅲ+Ⅱ,12例;Ⅲ+Ⅱ+Ⅰ,7例。69例患者同期行水平截骨颏成形术。结果　所有患者面下部宽度均较术前明显减小,容貌较术前明显改观。无面神经和下齿槽神经损伤等并发症发生。结论　根据患者畸形的程度采用口内入路的不同术式组合,可有效矫治各类下颌角嚼肌肥大畸形。Objective To evaluate the surgical corrective results of prominent mandibular angle with masseter muscle hypertrophy by using intraoral approach. Methods One hundred and twenty three cases with various degrees of prominent mandibular angle with masseter muscle hypertrophy were treated through intraoral approach. The basic surgical procedures included masseter muscle reduction (type Ⅰ), mandibular angle osteotomy (type Ⅱ) and angle-splitting osteotomy (type Ⅲ). The type Ⅰ was completed in 4 cases, type Ⅱin 16 cases, type Ⅲ + type Ⅰ in 56 cases, type Ⅲ in 19 cases, type Ⅲ + type Ⅰ in 9 cases, type Ⅲ + type II in 12 cases, type Ⅲ + type Ⅱ+ type Ⅰ in 7 cases. Genioplasty was simultaneously performed in 69 cases.Results The overwidth of the lower face was effectively corrected. The cosmetic results, as determined by both patients and surgeons, were good. No complications, such as facial never injury, or inferior alveolar never injury, occurred in any patients. Conclusions In order to reach good cosmetic results at the patients' lateral view and frontal view, considerations should be determined according to the degrees of the deformities and patient's desires, to choose suitable surgical procedures.

关 键 词：大畸形 嚼肌 手术矫治 下颌角矢状劈开去骨术 水平截骨颏成形术 下齿槽神经损伤 口内入路 适应证 优缺点 术式 三角形 单纯 患者 并发症 面神经 组合 术前 

分 类 号：R782[医药卫生—口腔医学]