Daw J L, de la Paz M G, Han H, Aitken M E, Patel P K
Division of Plastic and Reconstructive Surgery, Northwestern University Medical School, Chicago, IL, USA.
J Craniofac Surg. 1999 Nov;10(6):475-9.
The sagittal split ramus osteotomy is the most commonly used procedure to reposition the mandible surgically. Because it is more technically difficult and associated with a higher incidence of complications compared with other mandibular osteotomies, thorough knowledge of the anatomy of the mandibular ramus is a prerequisite. Anatomic measurements related to the mandibular foramen were obtained from 57 formalin-preserved non-Asian hemimandibles. As shown in previous reports, great variability was noted in the position of the mandibular foramen. However, these studies utilized Asian mandibles with a clear discrepancy in key anatomic measurements in comparison with the authors' data. This brings into question the validity of these earlier studies when applying their data to non-Asian groups. The "fade-out" point of the internal oblique ridge was found not to be a reliable anatomic reference for placement of the horizontal osteotomy along the medial ramus. Thus, familiarity with the described relationships of the mandibular foramen will assist in performing properly a sagittal split of the ramus and will reduce the chance for an unfavorable split.
矢状劈开下颌支截骨术是外科手术中最常用于重新定位下颌骨的手术。由于与其他下颌骨截骨术相比，它在技术上更具难度且并发症发生率更高，因此对下颌支解剖结构的透彻了解是先决条件。从57个用福尔马林保存的非亚洲半下颌骨中获取了与下颌孔相关的解剖学测量数据。如先前报告所示，下颌孔的位置存在很大差异。然而，这些研究使用的是亚洲下颌骨，与作者的数据相比，关键解剖学测量存在明显差异。这使得在将这些早期研究的数据应用于非亚洲人群时，其有效性受到质疑。发现内斜嵴的“消失”点并非沿下颌支内侧进行水平截骨的可靠解剖学参考。因此，熟悉所描述的下颌孔关系将有助于正确实施下颌支矢状劈开，并减少出现不良劈开的几率。
