半面短小症的手术治疗

Surgical treatment of hemifacial microsomia

目的总结半面短小症手术治疗的方法和经验。方法回顾性分析1982年4月至2004年8月在本院进行手术并有随访记录的58例半面短小症患者的临床资料,根据术前对患者病变的评估分类,采用针对不同累及部位及组织的手术方法治疗,术后3个月起随访,测量患者的面部歪斜角度变化,分别统计患者和医师对手术的满意率。结果手术后骨性面部歪斜角平均缩小4·2°,软组织面部歪斜角平均缩小2·9°;患者对手术的总体满意率为86·2%,医师对手术的总体满意率为84·5%。结论针对不同的部位和累及组织的半面短小症进行个性化的手术治疗是治疗此类疾病的有效方法。

Objective To summarize the methods and experiences in surgical treatment of hemifacial microsomia. Methods Fifty-eight cases of hemifacial microsomia that have been treated by plastic and reconstructive surgery and followed-up in our department during last 20 years have been reviewed. Every patient＇s characteristic was assessed by physical examination, photography, craniofacial cephalometry before planned the method of surgery. Different surgical treatments were chosen according to the side and the structures involved in the abnormities and the severity of hemifacial microsomia, and the cases were followed up since 3 months after the treatments. The follow-up lean of midline of the lower 1/3 face with that before treatment is compared. The degrees of patients＇ and surgeons＇ satisfactions with the treatments were evaluated respectively. Results The average angle of lean of midline of skeletal and soft tissue of the lower 1/3 face decreased 4. 2° and 2. 9° respectively after treatment. Fifty （ 82. 6% ） cases satisfied with the outcome of the surgical treatment and surgeons satisfied with 84. 5% of the outcome of all the cases. Conclusions Individual surgical treatment based on the side and the structures involved in the abnormities can effectively correct facial asymmetry of hemifacial micrusomia.