下颌部畸形26例治疗体会  

Experience of treatment of mandibular deformity on 26 cases

作　　者：韩思源[1] 贺佳妮[1] 冷冰[1] 郭家妍[1] 李怒[1] 左娜[1] 刘海燕[1] 胡枫[1] 

机构地区：[1]中国医科大学附属第一医院整形外科,辽宁沈阳110001

出　　处：《中国美容整形外科杂志》2015年第7期389-392,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 总结近5年我科收治下颌部畸形的治疗经验,以指导临床工作.方法 收集26例下颌部畸形的病历资料,对其进行回顾性分析总结.安氏骨性Ⅲ类畸形、下颌前突、偏突颌畸形12例,其中,11例行下颌支矢状骨劈开术,1例行经口内入路下颌支垂直骨切开术,3例同期行颏成形术;下颌角肥大9例,其中,7例行下颌角外板劈开截除术,2例行下颌角磨骨术;小颏畸形5例,其中,3例行膨体隆颏术,2例行硅胶假体隆颏术.结果 所有患者术后效果满意,并发症发生率为7.69％.结论 下颌支矢状骨劈开术可以通过向前、向后移动或旋转远心骨段来完成下颌后缩、前突及偏突畸形的矫正,效果确切;下颌角磨骨术对于外翻型下颌角肥大治疗效果较好,对于下颌角肥大向外侧与后方较明显突出的患者应选用下颌角外板劈开截除术;填充颏成形术仅适用于轻、中度的小颏畸形,其他类型的畸形应考虑颏成形术.Objective To summarize the experience of treatment of mandibular deformity in recent 5 years in our department to guide the clinical work in the future. Methods The data collected from 26 cases of mandib ular deformities were performed retrospective analysis and summarized. Of 26 cases, 12 cases were skeletal class 111 malformation, mandibular protrusion, laterognathism of the mandible, in which 11 cases underwent sagittal split ramus osteotomy and 1 case underwent intraoral vertical ramus osteotomy and 3 of 12 cases underwent genio plasty, 9 cases were prominent mandibular angle, in which 7 cases underwent mandibular angle splitting ostecto my and 2 cases underwent mandibular angle ostectomy; 5 cases were microgenia, in which 3 cases underwent aug mentation with Teflon and 2 cases with silicone prosthesis. Results All of the patients were satisfied after opera tion. The complication rate was 7.69%. Conclusion Sagittal split ramus osteotomy could correct mandibular protrusion and laterognathism by forward or backward movement of the mandible and rotation of the distal frag ment. Mandibular angle ostectomy was effective for eversion type of prominent mandibular angle. Mandibular an gle splitting ostectomy should be considered in the mandibular angle with outward or backward prominent. Chin augmentation was only suitable for light to moderate microgenia. Genioplasty should be considered in other types.

关 键 词：下颌支矢状骨劈开术 下颌前突 偏突颌畸形 下颌角肥大 

分 类 号：R782.2[医药卫生—口腔医学]