下颌角整形术中去咬肌和不去咬肌两种术式对下颌运动功能的影响

Influence of the mandibular angle contouring surgery with and without partial resection of the masseter on the mandible motor function

目的:观察下颌角整形术中去咬肌和不去咬肌两种术式对下颌运动功能的影响。方法:选择2004-03/08南方医科大学附属珠江医院整形科门诊收治下颌角肥大手术治疗患者24例,手术均经口内入路行下颌角磨削截骨术,其中去除部分咬肌12例,不去咬肌12例。①最大开口度的测定:测量上下中切牙切缘之间的距离,再加上正中咬颌时前牙的覆盖,测量3次取其平均值。②最大前伸度的测定:测量上下中切牙切缘之间的水平距离,再加上正中咬颌时前牙的覆盖,测量3次取其平均值。测量时间分别为术前、术后1,2周,1,2,3,4,5,6个月。结果:纳入患者24例,均进入结果分析。去咬肌组术后1,2周,1,2,3个月患者最大开口度和最大前伸度均较术前比较明显降低犤以术后3个月为例,手术前后最大开口度分别为(43.4±5.0),(38.3±3.4)mm,手术前后最大前伸度分别为(8.5±0.7),(7.1±0.4)mm,P<0.01犦,至术后4个月已达到术前正常值范围;不去咬肌组术后1,2周,1,2个月患者最大开口度和最大前伸度均较术前比较明显降低犤以术后2个月为例,手术前后最大开口度分别为(40.4±4.0),(35.3±3.7)mm,手术前后最大前伸度分别为(9.0±0.6),(6.8±0.5)mm,P<0.01犦,至术后3个月已达到术前正常值范围;去咬肌组较不去咬肌组患者术后最大开口度和最大前伸度恢复至术前正常值范围的时间长。结论:下颌角整形术对患者口腔颌面系统的功能无明显长期不良影响;去咬肌和不去咬肌的患者术后下颌运动功能恢复时间明显不一样。

AIM：To observe the effect of mandibular contouring surgery with and without partial resection of the masseter muscle on the mandible motor function. METHODS： We chose 24 outpatients who underwent mandibular angle contouring surgery and received treatment in the Clinic of Orthopaedic Department, Zhujiang Hospital Affiliated to Southern Medical University from March to August 2004. All the patients were given mandibular contouring surgery, Among the 24 patients, partial resection of masseter muscle was performed in 12 cases and non-resection of masseter muscle in the other 12 cases. Maximal opening of mouth were measured for three times and the mean value was chosen. It was the axial distance between the edge of the upper and lower middle chip plus the distance of the upper chip over the lower chip; Maximal protrusion were measured for three times and the mean value was chosen. It was the level distance between the edge of the upper and lower chip plus the distance of the upper chip over the lower chip. The measurement was conducted before operation and at postoperative I and 2 weeks, 1,2,3,4,5 and 6 months. RSULTS： Twenty-four patients were enrolled in the experiment and all of them entered the stage of result analysis. In partial resection of the masseter muscle group, maximal opening of. mouth and maximal protrusion were significantly lower at postoperative I and 2 weeks , 1,2,3 months than before operation [ Taking at 3 months after operation as an example, the maximal opening of mouth was （43.4±5.0）, （38.3±3.4）mm before and after operation respectively , and the maximal protrusion was （8.5±0.7） and （7.1±0.4） mm respectively, P 〈 0.01],but they all recovered the normal level at 4 months after operation; In non-resection of the masseter muscle group, the maximal opening of mouth and maximal protrusion were significantly lower at postoperative 1 and 2 weeks, 1 and 2 months than before operation [ Taking at postoperative 2 months as an example, the maximal opening of mouth was （40.4±4.0）and（35.3±3.7） mm, respectively; and the maximal protrusion was （9.0±0.6）and（6.8±0.5） mm respectively, P 〈 0.01],but they recovered to the normal range before operation; The time of the maximal opening of mouth and maximal protrusion recovered to normal level was longer in partial resection of masseter muscle group than in non-resection of masseter muscle group. CONCLUSION： The mandibular angle contouring surgery has no longterm harmful effect on the function of oral and maxillofacial system; The recovery time of the mandible motor function is obvious different in partial resection of the masseter muscle group and non-resection of the masseter muscle group.