口内入路精确骨皮质劈除的面部轮廓重塑术

Facial contour reconstruction by splitting osteotomy of the lateral cortex with intraoral approach

目的介绍口内入路骨皮质劈除面部轮廓重塑术的手术设计、操作技巧及术后并发症的处理。方法自2007年12月至2009年2月，对150例求美者的肥大下颌角行口内入路下颌角区骨外板皮质劈除、磨削的方法整形；高突的颧骨体、颧弓行口内入路颧骨体、颧弓外侧骨皮质劈除及颧骨体局部磨削的方法缩小。所有手术均在局部浸润麻醉联合经鼻气管插管的全身麻醉下完成。术后口内放置引流，局部加压包扎。结果150例求美者中，术后双侧不对称者6例，有2例求美者行再次整形后双侧对称；面神经暂时性损伤者60例，术后2～6个月逐渐恢复正常；无其他严重并发症发生。所有手术均达到了预期效果。结论口内入路精确骨皮质劈除面部轮廓重塑手术是一种安全有效的手术方法，值得临床推广使用。

Objective To introduce the design and method of facial contour reconstruction by splitting osteotomy of the lateral cortex with intraoral approach and treatments of postoperative complications. Methods From Octomber 2007 to February 2009, splitting osteotomy of the lateral cortex with intraoral approach was employed for 150 cases who suffered from prominent malar bone. It was shortened by spliting lateral cortical plate and local grinding. Local infiltration anesthesia combined with general anesthesia through nasotracheal tube was employed in our plastic surgeries, drainage was placed in the operative wound and local pressure dressing was performed. Results All 150 cases were satisfied with the results except 6 cases with asymmetry of facial contour after operation in which 2 cases were repaired by secondary operation and 60 cases with facial paralysis which rehabilitated after 2 -6 months postoperatively. Conclusion Facial contour plasty by intraoral approach, splitting osteotomy of the lateral cortex is a safe and effective method.