颏体部斜行截骨术矫治宽颏畸形

Reducting oversize-chin by mandibular body-chin inclined ostectomy

目的:探讨矫正颏部宽大的新手术方法及适应证。方法:对发育性颏部宽大或下颌角截骨整形、颏部水平截骨整形后自觉颏部宽大的25例患者,采用下颌骨颏体部下缘斜行截骨术。手术截除自颏结节至角前切迹连线以下的下颌骨下缘,同时进行此连线间外侧骨皮质的打磨修整,术后通过正侧面面部形态观察,以及影像资料进行效果评价。结果:正面观:颏部和下颌体部中份较术前明显缩窄;侧面观:下颌缘光滑,下颌角、下颌体以及颏前点之间弧线自然美观,X线可见下颌下缘平整,颏结节不明显,无第二下颌角形成或原有第二下颌角消失;未发生颏神经断裂、下颌骨骨折等并发症。术后随访2个月～2年,效果满意。结论:颏体部下缘斜行截骨术可有效地缩窄颏部,同时矫正颏体部交界区域的突起、凹陷畸形,使颏部与下颌骨角体部协调美观、侧面观自下颌角至颏前点之间的曲线连续自然,可单独实施或作为下颌角截骨整形术、颏部水平截骨整形的补充手术,以达到重塑完美面型目的。

Objective To search a new method to correct oversize chin and to evaluate the surgical results. Methods The operation of mandibular body-chin inclined ostectomy has been performed on 25 patients who had oversize or square chin with different causes such as congenital macrogenia and secondary square chin. By combined ostectomy of the everted mandibular body-chin inferior border with buffing lateral cortical bone of that region,the operation corrected the un-beauty of frontal and lateral outline. The results were evaluated through appearances and image analyses. Results All patients undergone the operation were very satisfied with the improvement of their appearances through the three months to two year follow -up visits. The width of chin and mandibular body was reduced obviously, mandibular inferior border was smooth, in the X-ray image,mandibular inferior border was smooth, no secondary mandibular angle was exist. No severe complications occurred in all this cases, such as mental nerve neurotmesis, mandibular fracture etc. Conclusion The advantage of this operation is that it reduces the width of mandibular body and mental region effectively, corrects the protuberant or depressed deformity in boundary region of mandibular body- chin, coordinates mandibular angle and mental region. It can be an independent operation or a supplement to osteotomy of prominent mandibular angle and mental horizontal osteotomy for a charming face.