颧骨颧弓缩小截骨术的手术径路比较

Comparison of reduction osteotomy from different surgical approach in zygoma

目的:颧骨颧弓肥大多见于东亚人,通过颧骨颧弓缩小截骨术手术径路的比较,选择更简捷有效的截骨术。方法:比较经冠状切口或经口内或经口内加耳前切口暴露颧骨的颧突、颧弓部缩小术。截骨位于颧骨根部、颧弓远端,使高耸的颧骨内陷、下移,并固定。结果:通过经冠状切口截骨的45例,口内切口切、磨骨的12例,口内切口"L"形截骨的21例,口内加耳前切口的"L"形截骨的58例分类比较,结果显示:口内切口创伤小、切口隐蔽,明显优于冠状切口入路,而口内加耳前切口则使截骨术更为简捷有效。对大于45岁的患者,冠状切口可同时进行颧骨颧弓缩小和去皱术。结论:经口内加耳前切口的颧骨颧弓缩小截骨术,可作为首选方法之一。

Objective Prominent zygoma is commonly seen in East-Asian population. Zygoma reduction is the one of the best way for facial reshaping, therefore by selecting the most effective and reliable way for osteotomy. Methods There are several approaches for zygoma reduction such as coronal incision or intra-oral incision or intra-oral accompanied minor pre-auricular incision in order to gain exposure on protrusion of the zygomatic body and its arch. The osteotomy is performed on the lateral side of zygomatic body and zygomatic arch. In addition, the prominent zygoma is then repositioned by stepping inward but fixation is depends on the surgeon intention. Results In our study, seVeral approaches of the zygoma reduction were underwent comparison. 45 cases performed by coronal incision, 12 cases performed by intra-oral incision with shaving the protrusion zygoma, 21 cases performed by intra-oral incision with L-shape osteotomy and 58 cases performed by intra-oral and pre-auricular incision with L-shape osteotomy. In our experience, intra-oral incision is better than coronal incision and thus, the intra-oral and minor pre-auricular incision is more effective and reliable. Conclusion Recently, intra-oral and minor pre-auricular incision for zygoma reduction is more likely acceptable for surgeon as typical procedure.