口内入路下颌骨截骨面下部轮廓整形术

Osteotomy of mandible by intraoral approach for lower face reshaping

目的 探讨经口内入路行下颌角、下颌体、颏区联合截骨的面下部轮廓整形术的疗效.方法 采用口内入路,分别对双侧下颌角、下颌体行长弧形截骨,对颏部行T型截骨颏成形术截骨,并将剩余骨块重新同定,附着肌肉重新缝合.自2007年3月至2009年5月,对23例面下部宽大的求美者行面下部缩窄成形术.结果 所有求美者的术区均愈合良好,无血肿、切口裂开等现象发生.随访了13例求美者3～12个月.面下部明显变窄、缩小,下颌缘曲线流畅平滑,触摸不到切迹,面部整体轮廓满意,无面部神经受损等其他并发症出现.结论 经口内入路行下颌角、下颌体、颏区联合截骨术,是一种矫正宽大下颌及改善面部轮廓较为理想的方法,而且适用范围较广,并能保留颏部的解剖形态和下颌骨生物力学功能.

Objective To explore the curative effect of osteotomy of mandible （body, angle and mental region ） on lower-face reshaping. Methods The long barrel vault osteotomy with intraoral approach was adopted to cut mandible angle and body of both sides, genioplasty of T-shaped osteotomy was used for mental region and the remaining bones were refixed and the muscles attached were sutured again. From March 2007 to May 2009, 23 patients with broad lower face were performed the operation mentioned above. Results All 23 patients healed well without hematoma or disruption of wound. Thirteen patients were followed up for 3 - 12 months, all were satisfied with facial contour which lower faces were narrowed and decreased, the mandible edges were smooth without any notch and without any complications such as damage of facial nerve. Conclusion The mandible （ body, angle, together with mental region） osteotomy by intraoral approach is an ideal method for correcting broad mandible and improving facial contour with significant effect, perfect shape, extensive indications and total reservation in anatomical structure and biomechanical function.