下颌角截骨面下部轮廓重塑的研究

The Research of Basifacial Contouring Sculpture by Mandibular Angle Osteotomy

目的:下颌角截骨是面型轮廓重塑中最常见的一种手术,为了提高手术的精确性,避免不必要的损伤,我们对各种下颌角截骨术操作技巧进行探讨。方法:术前进行面部测量、下颌骨曲面断层X线和头颅正侧位定位X线片投影测量,设计截骨线和去骨量,术式选择口内切口下颌角截骨术、口内切口下颌角外板矢状劈开截骨术、耳后切口下颌角截骨术、耳后和口内联合切口下颌角截骨术;结果:面下部过宽同时下颌角肥大者单纯下颌角截骨效果往往不会很理想,需要同时进行下颌角外侧骨板部分去除,减少面下部的宽度,206例术后两侧对称,效果良好;1例面瘫;2例下颌骨骨折,术中做内固定;3例下颌骨体部成角,3个月后第二手术将突出部分磨平。结论:术前测量设计下颌角截骨的术式和截骨线是十分必要的,根据下颌角肥大的不同类型选择相适应的截骨术式。

Objective: Mandibular angle osteotomy is usually applied to the facial contouring sculpture.We evaluated the various techniques in order to enhance the precision and avoid unnecessarydamage. Method: Before operation the area and quantity resected bone were designed accordingto facial measurement, mandible pantomography and orthophoria and lateral localizedradiograph of skull. The Incises of mandibular angle osteotomy included intraoral, retroauricular orintraoral associated with retroauricular. Howerer, the sagittal resection of mandible outer table wasnecessary in all intraoral incise. Result: Single mandibular angle osteotomy was not satisfactory forthe patients having mandible hypertrophy with over-width basifacial contouring. Mandibular angleosteotomy combined with the sagittal resection of outer table of mandibular angle were required.Good symmetry and appearance were gained in 206 cases. One case had facial paralysis .Twopatients occured mandibular fracture during the operation. Three cases complicated angleddeformity at mandible body. Conclution: Reduction mandibuloplasty should be selected dependson varied types of mandibular angle hypertrophy before operation.