成人半侧颜面短小畸形下颌骨牵张成骨术的手术效果  

Efficacy of distraction osteogenesis of mandible in adult patients with hemifacial deformity

作　　者：杨亦楠 张智勇 石蕾 刘伟[1] 尹琳 尹宏宇 冯时 唐晓军 

机构地区：[1]中国医学科学院整形外科医院颌面整形外科中心,北京100144

出　　处：《中华医学美学美容杂志》2017年第6期375-378,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：北京市科学技术委员会首都临床特色应用研究基金（Z141107002514049）

摘　　要：目的 分析成人半侧颜面短小畸形患者牵张成骨术后的复发情况和手术效果.方法 对9例成人半侧颜面短小畸形患者的三维CT进行数字化测量及统计学分析.测量术前（T0）、牵张成骨术后（T1）及随访时（T2）双侧下颌升支高度、双侧下颌体部长度、颏前点至面中线距离,计算牵引延长后下颌骨的回缩复发率.结果 T0、T1及T2的下颌骨升支患侧与健侧长度比例分别为（58.19±12.06）％、（87.09±17.92）％和（81.13±30.57）％,差异有统计学意义（P＜0.05）.T0、T1及T2的下颌骨体部患侧与健侧长度比例分别为（87.70±7.86）％、（90.69±5.77）％和（90.11±5.62）％,T0与T1和T2差异有统计学意义（P＜0.05）.T0、T1及T2颏前点至面中线的距离分别为（13.66土3.28） mm、（4.926土1.75）mm和（6.616±1.82） mm,差异有统计学意义（P＜0.05）.复发率为（22.80±9.73）％.结论 下颌骨牵张成骨术后下颌骨升支及体部长度确有不同程度的回缩,但下颌骨长度较术前仍有明显增长,术后面下部不对称性明显改善.Objective To evaluate recurrence after mandibular distraction osteogenesis in adult patients with hemifacial microsomia using the digital three dimensional measurement.Methods Nine adult hemifacial microsomia patients were evaluated using the method of digital measurements with three dimensional computed tomography.Three observation points were studied：pre-operation （T0）,post-operation （T1） and follow-up （T2）.The length of ramus （H for normal side and h for affected side）,the length of body （L for normal side and l for affected side） and distance between pogonion and facial midline （D） were measured and the recurrence rate （R） was calculated.Results Percentages of h/H at T0,T1,T2 were （58.19±12.06）%,（87.09±17.92）%and （81.13±30.57）%,which had statistical significance respectively.2.Percentage of l/L at T0,T1,T2 were （87.70±7.86）%,（90.69± 5.77） % and （90.11±5.62）%,respectively,which had statistical significance between T0 and T1.3.Lengths of D at T0,T1,T2 were （13.66±3.28） mm,（4.926±1.75） mm and （6.616±1.82） mm,respectively,which had statistical significance between T0,T1 and T0,T1.4.Average R was （22.80± 9.73） %.Conclusions Varying degrees of recurrence do happen in both ramus and body of mandibular after distraction osteogenesis.While it is demonstrated that the mandible grows obviously after operation compared to that pre-operation,Meanwhile,the facial symmetry is also improved significiantly.

关 键 词：成人 半侧颜面短小畸形 牵引成骨 三维测量 复发 

分 类 号：R782[医药卫生—口腔医学]