亚单位分区治疗原则在下颌骨肥大整形中的应用

Practicing the subdivision as therapeutic principle in plastic surgery of mandible hypertrophy

目的:探讨亚单位分区治疗原则在下颌骨肥大整形中应用的特点和优势。方法:根据主要影响下颌骨肥大的结构因素,将下颌骨分为下颌支区、下颌角区、外斜线区、下颌体区、下颌下缘区、颏联合区;对168例实施下颌骨肥大整形术的就医者,按照上述亚单位分区治疗原则,根据不同的个体、不同的特征,在不同的亚单位分区中分别处理肥大的下颌骨,做到统筹规划、方案周到、重点突出、整体细化。结果:168例下颌骨肥大就医者中130例术后两侧对称,效果良好,正面变窄,侧面曲线通畅、美观。38例分别出现口唇皮肤损伤、血肿、感染、下颌缘不平整、下颌体部成角、下颌角区塌陷等症状,经进一步治疗后恢复正常。结论:根据下颌骨的亚单位分区原则,来指导术前测量设计和术中手术范围、方式及方法的选择,可使下颌骨肥大整形更加细化和量化,对于塑造一个更加完美、过渡自然的下颌骨具有更好的作用。

Objective Discussing the edges and characteristics of subdivision as therapeutic principle in Plastic surgery of mandible hypertrophy. Methods subdividing the mandible into ramus section, angle section,external oblique line, body section, inferior margin and symphysis section based on the structural factor of the disease. Treatment to the lesion subdivided in accordance with the principle in 168 patients undergoing the surgery, taking into account of their individual feature and condition, so as to achieve considerate overall planning, point underlining, and detailed procedures. Results 130 cases showed post-operative bisymmetry among the 168 patients with good outcome, slimmer front face and smooth sideway curve. 38 cases developed lips damage,hematoma,infection,unaligned submaxilla margin,angled mandible body and collapsed mandible angle,but recovered after further surgery. Conclusion The application of subdivision principle in the post-operative measurement and design as well as the selection of intra-operative surgical scope and approach in mandibular related surgery provided detailed and quantified operation, which is conducive in building a perfected mandible with natural transitional section.