摘要
目的探讨治疗半侧颜面发育不全畸形的各种正颌外科与其他手术方法组合,为提高治疗这种畸形的效果提供临床参考。方法根据11例半侧颜面发育不全患者的畸形程度,分别采用上颌LeFortⅠ型截骨术,下颌升支矢状劈开截骨术,下颌角成形术和颏成形术,其中有4例患者采用了腓骨肌皮瓣修复,3例患者采用了肩胛游离皮瓣修复,2例患者采用了腹部游离真皮脂肪瓣修复。并就该类患者颌面结构特征、手术方式的选择及疗效进行了回顾性分析。结果11例患者均顺利完成治疗,游离皮瓣均获得成功,所有患者面部偏斜畸形及咬合关系得到明显改善,5例患者咬合平面完全摆正,仍有6例患者咬合平面角维持在1°～4°。无长期不良并发症发生,随访期间无明显复发,患者对治疗结果感到非常满意。结论①畸形同时具有骨性畸形和软组织畸形,根据畸形的不同类型运用相应的手术方案,配合术前术后的正畸治疗,可获得咬合关系和容貌均满意的临床效果。②游离皮瓣的应用扩大了手术的适应证,使严重发育不全畸形得以较好矫正。
Objective To explore the methods of orthognathic treatment for hemifacial microsomia. Methods Eleven cases of hemifacial microsomia were treated by Lefort Ⅰ osteotomy, sagittal split ramus osteotomy, mandibular angle osteotomy, and genioplasty respectively, and repaired by four fibula flaps, three free scapular flaps and two abdomen derma -fat flap. The characteristics of the deformity, management of the cases, and the effects of therapy were analyzed respectively. Results The postoperative process of the eleven patients was uneventful. All the free flaps survived with the overall success rate of 100%. Facial appearance and oral function were improved greatly. Complete horizontalization of the occlusal plane was achieved in five of the patients, whereas a cant of 1 - 4 degrees persisted in the other patients. No permanent complication and no evidence of relapse were observed in any patient during the follow - up time. The corrective result was satisfactory. Conclusion Different operative methods were used according to the type of hemifacial microsomia. All the patients obtained satisfactory facial appearance and oral functions with pre - and post - operative orthodontic treatments. The application of free flaps extended the operative indication of hemifacial microsomia.
出处
《现代口腔医学杂志》
CAS
CSCD
北大核心
2008年第4期337-340,共4页
Journal of Modern Stomatology
