半侧颜面短小畸形下颌骨牵引成骨对咬肌的影响

The effect of mandibular distraction osteogenesis on the masseter muscle in hemifacial microsomia deformities

目的探讨半侧颜面短小畸形下颌骨牵引成骨对咬肌的影响。方法回顾性分析自2010年2月至2015年3月半侧颜面短小畸形患者共25例,借助Mimics软件重建患儿咬肌及头颅骨的三维立体图像,测量牵引成骨前后咬肌体积。结果下颌骨牵引成骨后,患儿健侧咬肌体积与术前相比,其差异无统计学意义(P>0.05),而患侧咬肌体积术后较术前明显增加(P<0.05)。ⅡA型和ⅡB型半侧颜面短小畸形患儿牵引成骨术后咬肌增加量差异无统计学意义(P>0.05);下颌升支后缘高度增加量与咬肌体积增加量无显著相关性(P>0.05)。结论下颌骨牵引成骨治疗半侧颜面短小畸形可能有助于促进患儿患侧咬肌生长,增加咬肌体积,改善半侧颜面短小畸形患儿肌肉软组织缺损情况。

Objective To explore the effect of mandibular distraction osteogenesis on the masseter muscle in cases of hemifacial microsomia deformity. Methods From February 2010 to March 2015, 25 cases of hemifacial microsomia deformity were retrospectively analyzed. Three-dimensional images of masseter muscle and cranial bones were reconstructed through Mimics software, and the volume of the masseter muscle before and after mandibular distraction osteogenesis was measured. Results There was no difference in masseter muscle volume in the uninjured side, pre-and post-surgery（P〉0.05）. The volume of the masseter muscle after mandibular distraction osteogenesis was significantly increased compared to pre-operation（P〈0.05）. The increased volume of the masseter muscle between type IIA and IIB hemifacial microsomia deformity patients after mandibular distraction osteogenesis showed no difference（P〈0.05）. There was no difference of the increased amount between the mandibular ramus posterior border height and masseter muscle volume（P〈0.05）. Conclusion Mandibular distraction osteogenesis may help to increase volume and promote growth of the masseter muscle in children with hemifacial microsonia deformity. It can improve the defect of muscle soft tissue in children with minor hemifacial microsomia