U型截骨术矫正下颌角肥大伴长颏畸形的临床效果

Clinical effects of en-bloc U-shaped osteotomy of the mandible in prominent mandibular angle patients with long chin

目的探讨矫正下颌角肥大伴长颏畸形的应用效果。方法2015年7月至2017年10月,对中国医学科学院整形外科医院整形十六科收治的21例咬合关系正常的下面部宽大伴长颏畸形患者,采用口内切口入路,行下颌骨角区、体部、颏部一次性整块U型截骨,改善面部轮廓。通过术前后影像资料对比、受术者满意度和手术并发症发生情况来评估手术效果,随访6~12个月,平均随访9.3个月。结果21例患者口内切口均一期愈合,无血肿、感染、骨坏死等并发症。16例患者术后出现下唇麻木,其中14例患者下唇感觉恢复,2例患者下唇麻木感觉缓解。全部患者对术后面部轮廓形态满意。结论下颌骨整块U型截骨术使下颌骨手术方法进一步改进,使下颌骨长度及宽度明显变小,能有效矫正下颌角肥大伴长颏畸形。

Objective To discuss a surgical treatment to correct prominent mandibular angle with long chin.Methods From July 2015 to October 2017,21 patients with malocclusion who suffered from prominent mandibular angle with long chin underwent en-bloc mandibular U-shaped osteotomy through oralincision in order to shorten mandibular angle,the body of mandible and the chin and to improve the facial contour.We assessed the surgical effect through comparison of radiologic images, satisfaction of patients and surgical complications between pre-operation and post-operation.Results In this group,all oral incisions had healing by first intention,without hematoma,infection and osteonecrosis.Low lip numbness occurred in 16 patients.After following up for 6-12 months,the lower lip numbness was recovered in 14 patients and relieved in 2 patients.All patients satisfied with the appearance after the operation.Conclusions En-bloc mandibular U-shaped osteotomy is an improvement for mandible surgery treatment.Its osteotomy line involves the whole mandible,which makes the length and width of mandible smaller apparently.This procedure can effectively correct prominent mandibular angle with long chin.