15内与耳后联合切口的下颌角截骨术26例临床报告

Mandibular angle ostectomy via intraoral incision combined with retroauricular incision： 26 cases report

目的 提供一种具有独特优势的下颌角截骨术式,以及经测量选择适合病例的客观方法.方法 术前经X线头颅定位片测量,选择符合下颌升支过长特征的患者.采用口内与耳后联合切口.由耳后切口置入电锯截骨并引流,行口内切口辅助完成剥离,按术前测量结果确定截骨线位置、取骨等操作.自2006年9月至2010年4月,对26例女性患者行下颌角截骨术.结果 所有患者的术中及术后均无较严重的并发症出现;术后随访患者5～12个月,除3例患者对效果不满意外,余者均满意.结论 口内与耳后联合切口的下颌角截骨术主要适用于下颌升支过长的患者,与单纯采用口内或耳后切口的术式相比具有独特的优势,对于经验尚未丰富的临床医师尤为安全并易于掌握;采用X线头颅定位片测量法,对术前客观选择病例及术中截骨线定位具有指导意义.

Objective To supply a different unique mandibular osteetomy and objective method of cases＇ selection by preoperative cephalometric X-ray measurements. Methods Preoperative measurement and analysis of cephalometric X-radiographs were performed and the patients with excessive mandibular ramus were selected. The mandibular angle ostectomy was adopted through the intraoral incision combined with retroauricular incision, the retroaurieular incision was used for the electric saw insertion and draining and the intraoral incision was used for the following operations like completing dissection, making sure the position of ostectomy by preoperative measurements and taking the fragments out. From September 2009 to April 2010, 26 female patients were performed the operation mentioned above. Results Complications were not occurred in all patients during and after operations. After 5 - 12 months following up, all patients were satisfied with the results except 3 cases. Conclusion Mandibular angle ostectomy via intraoral incision combined with retroauricular incision can be used for these patients with the excessive mandibular ramus which surpass the osteetomy via intraoral incision or retroauricular incision; the surgery is safe and easy for the inexperienced surgeons to operate; preoperative measurement and analysis of cephalometric X-radiographs are important for the selection of the patients.