高密度多孔聚乙烯假体置入隆颏在面下1／3轮廓成形术中的应用

Application of high-density porous polyethylene implant in chin augmentation in contour plastic surgery of low face

目的探讨高密度多孔聚乙烯（porous high-density polyethylene，Medpor）假体置入隆颏在面下1／3轮廓成形术中的应用效果。方法149例同时行口内入路Medpor假体置入隆颏及面下1／3轮廓整形，其中行双侧下颌角截骨成形术121例，行双侧下颌角截骨成形术及双侧颧骨截骨降低术28例，并进行术前术后照相对比，观察判断临床效果。结果术后145例（97．3％）颏部外形及面下1／3轮廓改善满意。2例（1．3％）感觉颏部突度改善欠佳，其中1例再次行Medpor假体取出及颏部截骨前移颏成形术。1例（0．7％）感觉颏部假体偏大，行二次手术将假体修小；1例（0．7％）术后6个月因假体偏斜改行颏部截骨颏成形术。20例（13．4％）术后短期感觉下唇麻木，1～3个月后基本消失。随访期间没有发现伤口血肿、感染及假体外露、断裂等并发症。结论Medpor假体组织相容性好，同时经口内入路置入隆颏及下颌角截骨成形术在面下1／3轮廓整形中效果良好。

Objective High-density porous polyethylene （Medpor） has been widely used in chin augmentation in recent years. The study aimed to observe the outcomes of clinical use of high-density porous polyethylene implant in chin augmentation in contour plastic surgery of low face. Methods From 2005 to 2008, 149 cases of chin augmentations intraorally with Medpor implants combined with were collected. 121 of them received bilateral mandibular angle osteotomy and 28 cases received bilateral mandibular angle osteotomy and bilateral malar reduction simultaneously. They wre all females aged from 17 to 46 years. The patients were followed up for 6 to 36 months （average 24 months） and photographs were taken before and after operations. Clinical outcomes were observed and analysed. Resuits 145 patients （97. 3 %） were satisfied with their chin and contour of low face. 2 patients （1.3%）were not satisfied with the projection of their chin, and 1 of them were admitted to take out the implant and received sliding advancement genioplasty. 1 patient（0.7%） felt the implants was too large to some extent and was admitted to modify the implant. 1 patient （0. 7 %） received genioplasly 6 months after operation because of the deviation of the implant. 20 patients （13.4 %） felt numbness of the lower lip which gradually disappeared 1 to 3 months postoperatively. Complications such as infection, edema and extrusion, break of the implant were not found during the following period. Conclusions Medpor is an excellent biomaterial with good biocompatibility. Simultaneously chin augmentation with Medpor combined with bilateral mandibular angle osteotomy intraorally shows a good result in contour plastic surgery of low face.