颧骨复合体缩小术后面中部松垂的解剖性复位研究

Anatomic reduction of midfacial sag after intraoral reduction malarplasty

目的研究尸体颧部的解剖特点,设计口内入路颧部高突畸形整复术后的软组织解剖性复位方式,避免术后面中部组织松垂并发症的发生。方法设计口内入路上移颧骨复合体,悬吊颧部肌层及骨膜,覆盖颧骨复合体,利用耳颞部小切口固定于颞深筋膜。临床上选取24例颧部高突患者,手术中“L”型截骨后,应用该方法进行颧部软组织悬吊。结果术后中面部宽缩窄距离(10.22±1.97)mm,双侧颧骨复合体基本对称。术后随访4～6个月,所有患者未出现面中部松垂和鼻唇沟加深的情况。结论口内入路进行颧部肌层及骨膜悬吊可有效避免颧部高突畸形整复术后面中部松垂的并发症,远期效果有待进一步观察。

Objecitve To study the techical refinements of intraoral reduction malarplasty to prevent postoperative drooping of the cheek. Mehtods Twenty-four patients with prominent zygomatic complex underwent reduction malarplasty from January 2005 to January 2006. In all these cases, the osteotomized malar complex was repositioned superioposteriorly, and the perioral muscles and periosteum were redraped accordingly and fixed on deep temporal fascia. Results Symmetry between the left and right complexer were achieved, with a decreased midfacial width of 10.22±1.97 mm. During postoperative follow-up of 4 to 6 months, all the patients had satisfactory operative results, and reported no postoperative drooping of cheek. Conclusion This method of superioposterior reduction of the perioral muscles and periosteum is simple and effective, but the long-term result needs to be observed.