改良双侧下颌支矢状劈开术固定法在矫正面部不对称畸形中的初步应用

中国口腔颌面外科杂志 ›› 2014, Vol. 12 ›› Issue (1): 30-34.

改良双侧下颌支矢状劈开术固定法在矫正面部不对称畸形中的初步应用

黄立^{1*, *}, 柳稚旭^{2*, *}, 张雷², 沈舜尧², 王旭东²

1.福建医科大学附属第一医院口腔颌面外科,福建福州 350005; 2.上海交通大学附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海 200011

收稿日期:2013-10-11 修回日期:2013-11-25 出版日期:2014-02-10 发布日期:2014-02-10
通讯作者: 王旭东,E-mail:xudongwang70@hotmail.com
作者简介:黄立(1976-),男,硕士,主治医师,E-mail:huangli_1222@163.com；柳稚旭(1987-),女,在读硕士研究生。 *并列第一作者
基金资助:
国家自然科学基金(81271122); 上海市自然科学基金(10ZR1418000)

Correction of facial asymmetry deformity using modified BSSRO and fixation method

HUANG Li¹, LIU Zhi-xu², ZHANG Lei², SHEN Shun-yao², WANG Xu-dong²

1. Department of Oral and Maxillofacial Surgery, First Hospital of Fujian Medical University. Fuzhou 350005; 2. Department of Oral and Craniomaxillofacial Science, Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine， Shanghai Key Laboratroy of Stomatology. Shanghai 200011, China

Received:2013-10-11 Revised:2013-11-25 Online:2014-02-10 Published:2014-02-10
Supported by:
Supported by National Natural Science Foundation of China (81271122) and Natural Science Foundation of Shanghai Municipality(10ZR1418007).

摘要/Abstract

摘要： 目的: 研究双侧下颌支矢状劈开术(BSSRO)中保留凹陷侧近心端骨板联合双皮质螺钉固定法在矫正面部不对称畸形中应用价值。方法：选择2013年1月—2013年7月间在上海交通大学医学院附属第九人民医院行正颌手术治疗的8例成年偏突颌畸形患者作为研究对象,术前进行临床检查和三维CT检查,确定双侧咬肌区的不对称情况,术中常规行BSSRO和(或)上颌骨Le Fort I型截骨术。在下颌骨旋转后退后,肥大侧去除近心端多余骨板行4孔小钛板固定,凹陷侧保留近心端多余骨板用双皮质螺钉固定。术后3个月检查患者面部对称性的改善情况,并通过正位片测量、计算患者手术前、后两侧结构的对称性,评估该方法的有效性。利用SPSS 20.0 软件包对数据进行配对t检验。结果：8例患者的面部不对称性均得到很好改善,未出现钛钉脱落、骨块移位和复发等情况。手术前、后患者面部对称性相关指标的差值具有统计学意义(P<0.05)。结论：BSSRO中保留凹陷侧近心端骨板联合双皮质螺钉固定法能更有效地矫正面部不对称畸形,可安全应用。

关键词: 面部不对称畸形, 改良双侧下颌支矢状劈开术, 正颌手术

Abstract: PURPOSE: To investigate the clinical application of reserving the proximal bone segment in the concave side, and osteosynthesis with three bicortical titanium screws placed in a triangular shape for stabilization during bilateral sagittal split ramus osteotomy (BSSRO) for correction of facial asymmetry deformity. METHODS: Between January 2013 and July 2013, 8 adult patients with lateroprognathism in Shanghai Ninth People’s Hospital underwent orthognathic surgery. The asymmetry in the masseter region was evaluated based on clinical examination and three-dimension CT examination. After regular maxillary LeFort I osteotomy and BSSRO, the proximal bone segment in the hypertrophy side was resected and fixed using four-hole mini-titanium plate whereas the proximal bone segment in the concave side was reserved, and osteosynthesis with three bicortical titanium screws placed in a triangular shape for stabilization. The security and validity of the method were evaluated based on the examination of facial symmetry 3 months after operation：the face asymmetry was measured on postero-anterior(P-A) cephalogram. The data was compared before and after surgery with paired t test using SPSS 20.0 software package. RESULTS: The facial asymmetry in all 8 patients was effectively corrected, and radiographic facial asymmetry was found obviously decreased (P<0.05) and no complications were noted. CONCLUSIONS: Reserving the proximal bone segment in the concave side, and fixed with three bicortical titanium screws placed in a triangular shape could effectively and safely correct the facial asymmetry deformity.

Key words: Facial asymmetry deformity, Modified BSSRO, Orthognathic surgery

黄立, 柳稚旭, 张雷, 沈舜尧, 王旭东. 改良双侧下颌支矢状劈开术固定法在矫正面部不对称畸形中的初步应用[J]. 中国口腔颌面外科杂志, 2014, 12(1): 30-34.

HUANG Li, LIU Zhi-xu, ZHANG Lei, SHEN Shun-yao, WANG Xu-dong. Correction of facial asymmetry deformity using modified BSSRO and fixation method[J]. China J Oral Maxillofac Surg, 2014, 12(1): 30-34.

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