下颌角弧形截骨术后咬肌厚度的变化  

Change of masseter muscle following curved osteotomy of prominent mandibular angle

作　　者：李敏[1] 归来[1] 刘剑峰[1] 黄绿萍[1] 张智勇[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》2007年第2期78-81,共4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：目的观察下颌角弧形截骨术后咬肌形态的变化，为下颌角肥大矫治手术提供指导。方法采用超声成像技术对10例行下颌角弧形截骨术的受术者行双侧（20侧）咬肌厚度测定，测量时间为术前及术后半年，于受术者肌肉松弛状态下分别在3个不同平面（A平面：口角与耳垂连线所在平面；B、C平面分别为与A平面平行，跨度为1cm的上下两平面）测量咬肌的最大厚度，观察比较咬肌厚度变化。结果A平面咬肌厚度术前平均值为（1．168±0．155）cm，术后平均值为（1．133±0．176）cm，与术前相比差异无统计学意义（P〉0．05）；B平面咬肌厚度术前平均值为（1．215±0．178）cm，术后平均值为（1．108±0．210）cm，与术前相比差异无统计学意义（P〉0．05）；C平面咬肌厚度术前平均值为（1．223±0．192）cm，术后平均值为（0．979±0．118）cm，与术前相比差异有统计学意义（P〈0．05），术前术后咬肌厚度减少值平均为（0．244±0．121）cm，术前术后减少百分比平均为（19．22±7．785）％。结论下颌角弧形截骨术后近角区咬肌可发生明显萎缩，轻、中度下颌角肥大者可单纯行下颌角弧形截骨术，无需切除咬肌。Objective To explore the changes of the masseter muscle following cured osteotomy of the prominent mandibular angle and supply guidance for the resection of mandibular angles. Method Ultrasonography was used to assess the thickness changes of masseter muscle that took place after curved osteotomy in 10 patients （20 hemimandibles） with following-up for six months. The measurements were performed under relaxing condition in three cross sections of masseter muscle. Plane A contains the line from mouth angle to ipsilateral ear lobe. Planes B and C are two parallel planes, respectively, above and below to the plane A with the distance of 1 cm between them. Results The preoperative thickness of masseter muscle in plane A was （1. 168±0. 155） cm, and the postoperative thickness was （1. 133 ± 0. 176）cm. Statistic analysis showed no significant difference （P〉0.05）. the preoperative thickness of masseter muscle in plane B was （1. 215±0. 178） cm, and the postoperative thickness was （1. 108± 0. 210）cm, with no statistic significance （ P 〉 0.05） . the preoperative thickness of masseter muscle in plane C was （1. 223 ±0. 192） cm, and the postoperative thickness was （0. 979±0. 118） cm, with no statistic significance （P 〈0.05）. The thickness of masseter muscle was reduced by （0. 244±0. 121） cm, which was approximately （19.22±7. 785） % of its original thickness. Conclusions The master muscle near the mandibular angle becomes atrophy after cured osteotomy. Patients with mild or moderate prominent mandibular angles can be treated with cured osteotomy only without masseter excision.

关 键 词：下颌角肥大 咬肌 超声成像 下颌角截骨术 

分 类 号：R7[医药卫生—临床医学]