颧骨整形术后修复手术的原因和治疗策略

Revision surgery for malar reduction： causes and treatment strategies

目的探讨颧骨整形术后修复手术的原因、初始手术方式与修复手术的相关性以及个性化修复的治疗策略。方法2003年1月至2017年12月，中国医学科学院整形外科医院颅颌面二中心收治颧骨整形术后修复患者27例，均接受不同方法手术修复，包括双支撑颧骨截骨降低术、颧骨颧弓原位截骨坚固内固定术、颧骨打磨术、自体骨移植术等。结果根据不同的初次手术方式及修复要求，选择应用上述手术方法修复颧骨截骨术后修复患者27例，其中22例为单次修复、5例为多次修复，随访10～12个月，获得满意疗效。结论颧骨整形术后并发症与颧骨初次整形手术方式相关，根据畸形情况及修复要求，设计不同修复方案进行个性化修复，可获得较好的临床效果。

Objective To discuss the correlation between initial rnalar reduction procedures and the method of revision procedures and the personalized treatment strategies for the second deformity of postoperative prominent malar complex. Methods From January 2003 to December 2017, 27 patients underwent personalized revision surgery of rnalar reduction according to the different second deformity of rnalar complex. The surgical technique included the double support rnalar reduction technique, orthotopic malar osteotomy technique, malar bone grinding surgery, and autogenous bone transplanta tion. Results A total of 27 patients subjected to revision surgery for malar reduction between November 2006 and December 2017 were retrospectively reviewed. 22 patients were satisfied with aesthetic outcomes after the first revision procedure, while 5 patients were satisfied after 2 or 3 procedures follow-up for 10 to 12 months. Conclusions The incidence of complications after rnalar reduction is related to the first surgical method. According to the unsatisfactory results, it can be repaired individually to obtain a better clinical repair effect.