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作 者:李敏[1] 归来[1] 张智勇[1] 吕长胜[1] 黄绿萍[1] 牛峰[1] 金骥[1] 刘剑锋[1]
机构地区:[1]中国医学科学院中国协和医科大学整形外科医院颅颌面外科,北京100041
出 处:《中华医学美学美容杂志》2006年第6期323-327,共5页Chinese Journal of Medical Aesthetics and Cosmetology
基 金:北京市科委基金资助项目(编号:Y0204004040891)
摘 要:目的探讨经口内入路不同术式矫正下颌角肥大的适应证及疗效。方法应用下颌角弧形截骨术矫正60例中重度下颌角肥大,下颌角外侧骨板矢状劈开截骨术矫治10例轻中度下颌角肥大,通过X线头影测量评价疗效。结果下颌角弧形截骨组:术后下颌角角度为(129.491±6.277)°,下颌平面角角度为(34.447±5.068)°,下颌升支后缘切线与前颅底平面的前下交角角度为(92.702±5.520)°,面下部宽度为(10.797±0.688)cm,与术前比较差异均有统计学意义(P<0.05),接近于正常人群。下颌角外侧板矢状劈开截骨组:术后面下部宽度为(11.200±0.675)cm,与术前比较差异有统计学意义(P<0.05);术后下颌角角度为(123.444±3.468)°,下颌平面角为(30.444±3.664)°,下颌升支后缘切线与前颅底平面的前下交角为(95.333±3.000)°,与术前比较差异均无统计学意义(P>0.05)。所有患者容貌较术前均有明显改观,无下齿槽神经损伤、下颌骨骨折等并发症发生。结论针对下颌角肥大不同类型采用不同截骨方法,可有效矫治下颌角肥大畸形。Objective To discuss the indication of different intraoral approaches and to evaluate the surgical results of prominent mandibular angle. Methods Sixty cases of moderate or severe prominent mandibular angles were treated with curved osteotomy. Ten cases of mild or moderate prominent mandibular angles were treated with angle splitting osteotomy. The results were evaluated with cephalometric analysis. Results The postoperative mandibular angle, mandibular plane angle, ramus planesella nasion angle, and the width of lower face of curved osteotomy group were (129. 491± 6. 277)°, (34.447±5.068) °, (92.702±5.520)°, and (10. 797+0. 688)cm, respectively. The difference between these preoperative and postoperative values had statistic significance (P〈0. 05). And those postoperative values were close to normal. In another group, angle splitting osteotomy group, postoperative width of lower face was (11. 200 ± 0. 675)cm, and statistic analysis showed significant difference from preoperation (P〈0.05). While the postoperative mandibular angle, mandibular plane angle, and ramus plane-sella nasion angle were (123. 444±3. 468)°, (30. 444±3. 664)°, and (95. 333±3. 000)° respectively. Statistic analysis showed no significance (P〉0.05). The cosmetic results were satisfied. No complications, such as inferior alveolar nerve injury and mandible fracture, occurred in any patient. Conclusions Suitable surgical procedures should be taken according to the classification of the deformity to attain better cosmetic results.
关 键 词:下颌角肥大 口内入路 下颌角弧形截骨术 下颌角外侧骨板矢状劈开截骨术
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