上颌前部截骨术对上颌前突患者鼻部形态的影响  

Effect of anterior maxillary segmental osteotomy on nasal morphology of patients with maxillary protrusion

作　　者：都乐 张栋 靳小雷 宗宪磊 宋国栋 吴荣薇 DU Le;ZHANG Dong;JIN Xiaolei;ZONG Xianlei;SONG Guodong;WU Rongwei(The 16th Department,Plastic Surgery Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院整形外科医院整形十六科,北京市100144

出　　处：《组织工程与重建外科》2021年第3期231-234,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨上颌前部截骨术对上颌前突患者鼻部形态的影响。方法2015年1月至2019年4月,共收治女性上颌前突畸形患者41例。所有患者行上颌前部截骨后推术,并于术前及术后10~12个月行头颅CT平扫。以mimics17.0软件对手术前后CT扫描结果进行三维重建,测量手术前后各解剖标记的三维数据,系统分析患者鼻部软组织变化。结果所有患者伤口均一期愈合,上颌前突外形明显改善,随访10~12个月,畸形无复发。分析鼻部区域三维解剖数据,术后患者的鼻长无明显变化,鼻翼最宽宽度、鼻翼基底宽度、鼻翼切线点最宽宽度、鼻翼-面角及鼻唇角显著增加。结论上颌前部截骨后推术对患者上颌前突改善明显,但对鼻部形态存在不良影响,对于计划接受上颌前部截骨后推术的患者应进行相关评估。Objective To investigate the effect of anterior maxillary segmental osteotomy(AMSO)on nasal morphology of patients with maxillary protrusion.Methods In a retrospective study from January 2015 to April 2019,41 female patients with maxillary protrusion were treated.All patients underwent AMSO and push back.They underwent head CT scan before operation and 10-12 months after operation.Using mimics17.0 software,3D reconstruction of CT scanning result before and after operation were performed.The 3D data of each anatomical parameters before and after operation were measured,and the changes of nasal soft tissue were analyzed systematically.Results All the wounds healed in the first stage,resulted in a significant reduction in maxillary protrusion.The patients were followed up for 10-12 months,and no recurrence was found.Analysis of the three-dimensional anatomical data of the nasal region showed that there was no significant change in the nasal length,but the width of alar base,width of alae nasi,width of nasal alar tangent points,alar nosi break angle and nasolabial angle increased significantly.Conclusion All patients underwent AMSO has a significantly reduction of maxillary protrusion.However,it has an unintended effect on the nasal morphology and should be evaluated in patients scheduled for AMSO.

关 键 词：上颌前部截骨术 鼻部软组织变化 三维测量分析 

分 类 号：R622[医药卫生—整形外科]