经口内切口行下颌角及骨外板截除的面下部轮廓整形术

Reshaping of basifacial contour with mandibular angle and external circumferential lamella excision through intraoral incision

目的探讨经口内切口行下颌角及骨外板截骨术对面下部轮廓的治疗效果。方法在鼻气管插管全身麻醉下，对68例因下颌角肥大致方形脸的患者行口内切口定位，并肿胀麻醉，充分显露下颌截骨区，直视下用来复锯行下颌角和部分下颌骨升支、水平支外板斜行截除术，颏孔周围以小圆柱磨头磨平，放置负压引流并关闭黏骨膜切口。结果所有患者术中一次性截除的骨片完整，术中及术后无大出血、血肿、感染和神经损伤等并发症发生。术后随访效果满意，切口均I期愈合。结论经口内切口行下颌角及骨外板斜行截骨的手术操作方法简单、安全，手术时间短且效果良好，适合大部分情况的下颌角肥大的治疗，值得临床推广。

Objective To study the therapeutic outcomes of mandibular angle and external circumferential lamella excision through intraoral incision in the reshaping of basifaeial contour. Methods Under general anes- thesia through the nasotracheal tube, 68 patients with square face because of the mandibular angle hypertrophy were performed mandibular angle and external circumferential lamella excision through intraoral incision. The pro- cecures were following： exposure of the region of mandibular osteotomy, oblique excision of mandibular angle and part ascending and horizontal branches with reciprocating saw under naked eye, grind smTound mental foranaen, placement of negative pressure drainage and suture of incision. Results Bone fragments from all patients was u- nitary and all incisions healed primarily. During and after operation, there were no complications, such as inferior alveolar nerve injury, mandible fracture and massive hemorrhage. The postoperative effects were satisfied after following up. Conclusion It is a good method of mandibular angle and external circumferential lamella excision through intraoral incision in the reshaping of basifacial contour and it is worthy of widely spreading.