计算机辅助鼻腔周截骨联合LefortⅠ型截骨和BSSRO矫治高低眼畸形的效果

Outcome of computer-assisted perinasal osteotomy combined with LefortⅠosteotomy and BSSRO in the correction of high-low eye deformity

目的探讨计算机辅助鼻腔周截骨联合LefortⅠ型截骨和双侧下颌矢状劈开术(BSSRO)矫治高低眼畸形的效果。方法纳入6例高低眼畸形患者,在计算机辅助下行鼻腔周截骨联合LefortⅠ型截骨和BSSRO治疗。记录手术效果、患者满意度、计算机辅助设计时间和手术时间,评价骨块就位准确度,记录术后并发症发生情况,并观察鼻根部小切口愈合情况。结果计算机辅助鼻腔周截骨联合LefortⅠ型截骨和BSSRO矫治高低眼畸形效果较好,患者满意度高。计算机辅助设计时间为(8.4±1.9)h,鼻腔周截骨时间为(87.3±17.7)min,LefortⅠ型截骨和BSSRO截骨时间为(125.5±38.0)min,上下颌骨分块截骨时间分别为(32.5±8.2)min、(328.5±9.2)min。骨块就位与术前规划的误差小,就位准确度高。患者术后未出现复视、反射性头痛、干鼻症及嗅觉丧失等并发症,鼻根部切口瘢痕不明显。结论计算机辅助鼻腔周截骨联合LefortⅠ型截骨和BSSRO可有效矫治高低眼畸形,明显改善患者颜面部的不对称,术后并发症少,患者满意度高。

Objective To investigate the outcome of computer-assisted perinasal osteotomy combined with LefortⅠosteotomy and bilateral sagittal split ramus osteotomy(BSSRO)in the correction of high-low eye deformity.Methods A total of 6 patients with high-low eye deformity were enrolled and underwent computer-assisted perinasal osteotomy combined with LefortⅠosteotomy and BSSRO.The surgical effect,patient satisfaction,computer-assisted design time and operation time were recorded,the accuracy of bone block placement was evaluated,the occurrences of postoperative complications were recorded,and the healing of the small incision at nasion was observed.Results The computer-assisted perinasal osteotomy combined with LefortⅠosteotomy and BSSRO had a good effect on the correction of high-low eye deformity,with high patient satisfaction.The computer-assisted design time was(8.4±1.9)hours,the perinasal osteotomy was(87.3±17.7)minutes,the time of LefortⅠosteotomy and BSSRO osteotomy was(125.5±38.0)minutes,and the segmental osteotomy time of maxilla and mandible were(32.5±8.2)minutes and(328.5±9.2)minutes,respectively.The bone block placement had a small error compared with the preoperative planning,with high positioning accuracy.There was no complications such as diplopia,reflex headache,dry nose or anosmia after operation,and the scar of the incision at nasion was not obvious.Conclusion Computer-assisted perinasal osteotomy combined with LefortⅠosteotomy and BSSRO can effectively correct high-low eye deformity,and significantly improve facial asymmetry with few postoperative complications and high patient satisfaction.