利用实时三维超声观察下颌角截骨术后咬肌的变化  

Changes of masseter muscle following curved ostectomy of prominent mandibular angle： a study of real-time 3D-ultrosonography

作　　者：李敏[1] 归来 徐永成[1] 刘文阁[1] 张旭东[1] 葛红[1] 

机构地区：[1]北京黄寺美容外科医院创伤美容科,北京100120 [2]中国医学科学院整形外科医院颅颌面外科

出　　处：《中华医学美学美容杂志》2010年第5期330-333,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 利用实时三维超声观察下颌角截骨术后咬肌的形态、功能变化,为下颌角肥大矫治手术提供参考指导.方法 利用实时三维超声对10例下颌角截骨患者行双侧咬肌形态及功能观察,观察时间为术前及术后半年,分别于患者下颌处在不同姿势下对咬肌进行三维重建和体积测量,并对张闭口过程中咬肌最厚处横断面进行动态观察,分析该横断面横纵径的变化幅度.结果 （1）重建的咬肌三维图像显示,截骨术后半年咬肌纵向长度变短,角区咬肌呈圆弧形,且较术前明显变薄;（2）术前咬肌体积平均值为（25.480±7.113）cm3,术后6个月时咬肌体积平均值为（18.222±3.028）cm3,与术前相比差异有统计学意义（P＜0.01）;（3）动态图像显示,截骨术后半年张闭口过程中咬肌最厚处横断面横纵径的变化幅度与术前相比,差异无统计学意义（P＞0.05）.结论 下颌角截骨术后咬肌萎缩部位主要位于角区,截骨术对咬肌功能并无明显影响;应用实时三维超声重建咬肌及观察咬肌活动方便快捷,对人体无损伤,利于重复,是一种观察测量咬肌的新方法.Objectives To investigate the changes in the masseter muscle following osteotomy of the prominent mandibular angle using real-time three-dimensional （3D） ultrasonography, and to supply guidance for resection of the mandibular angle. Methods Real-time 3D ultrasonography was applied preand post-operatively （over a 6-month follow-up period） to 10 patients who underwent curved osteotomy with the following objectives： （1） to reconstruct the morphological changes of the masseter under different conditions; （2） to assess masseter muscle volume changes, and （3） to obtain the dynamic morphological changes of masseter during mouth opening and closing. Results The reconstructed 3D images revealed that longitudinal diameters of masseter muscle decreased and angle regions changed to be arc-shaped with significant thinning 6 months after operation. The mean volume of masseter muscle was （18. 222 ±3. 028） cm36 months post-operatively, compared with the pre-operation mass of （25. 480 ± 7. 113） cm3,the statistical difference was significant （P〈0.01）. Transverse and longitudinal changes of the thickest masseter muscle section 6 months post-operatively were of no statistic difference （P〉0. 01） compared with pre-operation status during mouth opening and closing motions. Conclusion A certain extent of atrophy occurs primarily in the angle region of masseter muscle after mandibular angle ostectomy. However, these changes do not significantly impair masseter muscle function. Real-time 3D ultrasonography offers a novel, safe, and convenient technique for masseter muscle reconstruction and observation of masseter muscle movement.

关 键 词：下颌角肥大 截骨术 咬肌 实时三维超声 

分 类 号：R7[医药卫生—临床医学]