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颏成形术:长期头影测量、形态测量及感觉结果

Extended genioplasty: long-term cephalometric, morphometric and sensory results.

作者信息

Troulis M J, Kearns G J, Perrott D H, Kaban L B

机构信息

Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston 02114, USA.

出版信息

Int J Oral Maxillofac Surg. 2000 Jun;29(3):167-75.

Abstract

The incision, dissection, osteotomy design and fixation are important technical considerations when performing a genioplasty. The purpose of this study was to describe an extended genioplasty technique and to evaluate stability of position, form, surface area of the chin and incidence of postoperative sensory deficit. Records of 15 consecutive adult patients who underwent the extended genioplasty procedure were reviewed. The technique included incision in the labial vestibule from 2nd premolar to 2nd premolar, dissection, mobilization and retraction of the mental nerves, osteotomy parallel to the occlusal plane extending proximally to the antegonial notch and rigid fixation. Lateral cephalograms pre- and postoperatively and at the latest follow-up (> 6 months) were analyzed by linear and computer morphometric measurements to evaluate changes in position, shape and surface area of the chin. Neurosensory data from examination or questionnaire were recorded. Immediately postoperatively (T1), mean advancement in the sagittal plane was +8.7 mm and increase in surface area was +1.1 cm2. At the end of follow-up (T2), there were no significant changes (T2-T1) in chin position or surface area. Inferior border form was rated as smooth in all cases. Neurosensory evaluation revealed that 12/12 patients evaluated had functional sensory return at T2.

摘要

在进行颏成形术时,切口、解剖、截骨设计和固定是重要的技术考量因素。本研究的目的是描述一种改良颏成形术技术,并评估颏部位置、形态、表面积的稳定性以及术后感觉缺失的发生率。回顾了15例连续接受改良颏成形术的成年患者的记录。该技术包括在唇前庭从第二前磨牙至第二前磨牙做切口、解剖、颏神经的游离和牵拉、平行于咬合平面的截骨并向近中延伸至下颌角切迹以及坚固固定。通过线性和计算机形态测量分析术前、术后及最新随访(>6个月)时的头颅侧位片,以评估颏部位置、形状和表面积的变化。记录来自检查或问卷的神经感觉数据。术后即刻(T1),矢状面平均前移为+8.7mm,表面积增加为+1.1cm²。随访结束时(T2),颏部位置或表面积无显著变化(T2 - T1)。所有病例的下缘形态均评定为光滑。神经感觉评估显示,在T2时,接受评估的12/12例患者感觉功能恢复。

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