局麻下口内入路下颌角肥大整形术

Enlarged Mandibular Angle Reconstruction Through Intraoral Approach under Local Anesthesia

目的 探讨磨骨术在下颌角肥大整形术中的优缺点.方法 局麻下行口内入路,用带保护套的高速旋转锉磨削下颌骨升支的下半部、下颌角及下颌体、颏部的外侧及下缘,部分患者同时去除颊脂肪垫.结果 术后随访6-24个月,46例下颌角间距减少（13.1±2.4）mm,效果满意,满意率86.96%（40/46）;6例患者矫治不足;1例出现单侧骨质增生1年未愈;1例出现单侧血肿机化硬结,1年后软化吸收.结论 本术式相对于截骨术安全,磨骨量容易控制,但存在噪音大、手术时间相对较长等缺点,医务工作者仍需寻找更加完美的术式.

Objective To evaluate the advantages and shortcominges of the angle - grinding ostectomy for the enlarged mandibular. Methods Through intraoral approach under local anesthesia 46 pationts with enlarged mandibular werd treated by grinding the lower part of ascending ramus of mandible, body and angle of mandible. Lateral and lower border of chin with high spinning file with bracer in partal patiants, extraction of buccal fat pads were performed. Results After 6 - 24 months following up,interval of mandibular angler was shortend （ 13.1±2.4 ） ram, and the result of operation was satifactory without serious complications, the satifactory rate was 86.96% （ 40/46 ）. 6 pationts were not plastic enough. Hyperplasia took place in a pationt on single side of mandibular angle, after a year, it was not healed. Hematoma organization and induration appeared in a pationt on single side of mandibular angle. After a year, it was absorbed. Conclusion This operative method is simple, safe, and characterized with few complications, quick recovery and better conlour. It is extensively carried out easily.