24例半侧颜面发育不全畸形外科矫治的临床分析

Surgical management of hemifacial microsomia：a report of 24 cases

目的 对24例半侧颜面发育不全畸形的外科矫治作回顾性分析,探讨此类畸形综合治疗的效果. 方法 1991年7月至2006年8月,采用正颌外科技术、游离组织瓣法、Medpor植入术、牵引成骨技术综合治疗半侧颜面发育不全畸形24例,对患者年龄、畸形分类、手术时机、治疗方法及术后并发症等情况进行分析. 结果 所有患者术后均顺利完成治疗,术后患侧面部丰满度和面部对称性均得到明显提高,咬合关系均较术前明显改善,咬合平面基本摆正,其中8例血管化游离组织瓣均成活,无一例出现血管危象和组织瓣的坏死. 结论 根据患者年龄及畸形的分类选择合适的手术方案组合,对半侧颜面发育不全畸形的矫治可获得咬合关系和容貌均满意的效果.

Objective To investigate the therapeutic effect of combined treatment for hemifacial microsomia（HFM）. Methods From July 1991 to August 2006,24 consecutive patients with HFM were retrospectively analyzed.They underwent orthognathic surgery,free flap transplantation,Medpor implant,distraction osteogenesis.The patients age,deformity type,surgical timing,treatment methods and complications were analyzed. Results The treatment was completed in all the patients.The facial symmetry was improved dromatically after operation.The occlusion relationship was improved also with good occlusion plane.8 free flaps were survived with no necrosis. Conclusions The surgical treatment should be designed based on the age and deformity type in HFM.The occlusion relationship and appearance can be both improve markedly.