双切口辅以颌面外科技术矫治成人严重肌性斜颈畸形  

Treatment of adult severe muscular torticollis by double incision supplemented maxillofacial surgery technique

作　　者：朱裂[1] 杨春梅[2] 张文俊[1] 郭荣[1] 侯强[1] 江华[1] 章建林[1] 

机构地区：[1]上海第二军医大学附属长征医院整形外科,上海200003 [2]新疆医科大学附属第六医院

出　　处：《中国美容整形外科杂志》2013年第2期82-85,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨双切口辅以颌面外科技术矫治成人严重肌性斜颈畸形的方法及美学效果。方法自2009年4月至2012年2月，收治7例严重先天性肌性斜颈伴颌面畸形的患者，采用乳突区、锁骨上双切口行胸锁乳突肌多头切断松解辅以健侧下颌角弧形截骨技术矫治严重肌I生斜颈及其伴发的颌面不对称，颧骨发育低平者辅以颧骨整形。联合术后石膏托及颈托外固定3—6个月。结果术后患者切口均I期愈合，无感染及血肿发生。术后2周评定疗效：6例斜颈完全改善，1例斜颈明显改善，患侧乳突尖至胸锁关节的距离为（14．80±0．59）cm，较术前（11．44±0．78）cm明显延长。经辅助下颌骨或颧骨整形，患者面部对称度明显改善。结论胸锁乳突肌多头切断联合颌面外科技术治疗伴发颌面发育不良的成人严重肌性斜颈，可达到功能与外观的统一，获得较满意的疗效。Objective To investigate the therapeutic method and aesthetic effect of double incision sup- plemented maxillofacial surgery technique for adult severe muscular torticollis. Methods Between April 2009 and February 2012, totally 7 patients with severe muscular tortieollis were treated with multiple sternocleidomastold head amputation by double incision. All cases accompanying with mandibular asymmetry supplemented barrel vault osteotomy of contralateral mandibular angle. Zygomatic plasty was supplemented to the patients accompanying with zygomatic deficiency. Then, plaster support and neck collar were used after operation for 3 to 6 months. Results The incisions of all patients healed primarily, without infection or hematoma. The therapeutic effect was assessed 2 weeks after operation, outcome for torticollis were excellent in 6 case, good in 1 cases. The length between mastoid process and sternoclavicular joints measured 2 weeks postoperatively was （ 14.80 ±0.59） cm, which was much longer than that preoperatively. Comparing with the facies cranii before operation, facial symmetry was ameliorated significantly. Conclusion Multiple sternocleidomastoid head amputation supplemented maxillofacial surgery technique is an effective method for adult severe muscular torticollis accompanying maxillofacial deformity, which can achieve unity of neck function and facial appearance.

关 键 词：成人先天性肌性斜颈 下颌角成形术 颧骨成形术 胸锁乳突肌 多头切断术 

分 类 号：R622[医药卫生—整形外科]