Prendiville Stephen, Kokoska Mimi S, Hollenbeak Christopher S, Caplin David A, Cooper Margaret H, Branham Gregory, Thomas J Regan
Department ofOtolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, MO, USA.
Arch Facial Plast Surg. 2002 Oct-Dec;4(4):236-42. doi: 10.1001/archfaci.4.4.236.
The cervicomental (CM) angle is formed by the horizontal plane of the submental region and the vertical plane of the neck.
To compare the 2-dimensional effect of 4 surgical techniques on the CM angle in a human cadaver model.
Anatomic presurgical and postsurgical comparative study performed on human cadavers preserved with ethylene glycol.
Academic medical research center in St Louis, Mo.
Twelve cadaver specimens with obtuse CM angles with heads attached to the sternum and upper thorax.
Standard superficial musculoaponeurotic system rhytidectomy techniques were performed on all cadaver heads. Four techniques were compared: (1) platysmal plication; (2) platysmal plication and plication of the anterior bellies of the digastrics; (3) platysmal plication, plication of the anterior bellies of the digastrics, and interlocking mastoid-to-mastoid sutures; and (4) platysmal plication and interlocking mastoid-to-mastoid sutures.
The comparative changes in CM angle, the distance between the mentum and CM angle (mentum-CM distance), and the distance between the sternum and CM angle (sternum-CM distance) obtained with each of the 4 surgical techniques. Anatomic characteristics of the cadavers were also noted.
On average, the CM angle was significantly reduced after all procedures (P<.001). The mean sternum-CM distance increased significantly (P =.01). A trend toward significance was observed in the change in mentum-CM distance (P =.10). The presence of a low hyoid was significantly associated with a smaller CM angle after surgery (P =.009) and demonstrated a trend toward significance with an increase in mentum-CM distance (P =.07), but it was not significantly associated with an increase in sternum-CM distance (P =.58). After controlling for the presence of a low hyoid, the mastoid-to-mastoid suture significantly reduced the CM angle by approximately 11.3 degrees (P =.002) and the sternum-CM distance by 1.15 cm (P<.001).
The CM angle and the sternum-CM distance were significantly affected by all procedures. The addition of the mastoid-to-mastoid suture had the greatest effect on the CM angle, and the reduction in CM angle was strongly associated with an increase in the sternum-CM distance. Presence of a low hyoid was the only preoperative factor associated with a significant postoperative reduction in CM angle.
颈颏角由颏下区域的水平面与颈部的垂直平面形成。
在人体尸体模型中比较4种手术技术对颈颏角的二维影响。
对用乙二醇保存的人体尸体进行术前和术后解剖学对比研究。
密苏里州圣路易斯的学术医学研究中心。
12个尸体标本，其颈颏角为钝角，头部与胸骨和上胸部相连。
对所有尸体头部均采用标准的表浅肌肉腱膜系统除皱术技术。比较了4种技术：（1）颈阔肌折叠术；（2）颈阔肌折叠术加二腹肌前腹折叠术；（3）颈阔肌折叠术、二腹肌前腹折叠术加乳突间连锁缝合术；（4）颈阔肌折叠术加乳突间连锁缝合术。
4种手术技术各自所获得的颈颏角、颏部与颈颏角之间的距离（颏部 - 颈颏角距离）以及胸骨与颈颏角之间的距离（胸骨 - 颈颏角距离）的对比变化。还记录了尸体的解剖学特征。
平均而言，所有手术操作后颈颏角均显著减小（P <.001）。胸骨 - 颈颏角平均距离显著增加（P =.01）。在颏部 - 颈颏角距离的变化中观察到有显著趋势（P =.10）。低位舌骨的存在与术后颈颏角较小显著相关（P =.009），并且在颏部 - 颈颏角距离增加方面呈现出显著趋势（P =.07），但与胸骨 - 颈颏角距离增加无显著关联（P =.58）。在控制低位舌骨的存在后，乳突间缝合显著使颈颏角减小约11.3度（P =.002），使胸骨 - 颈颏角距离减小1.15厘米（P <.001）。
所有手术操作均对颈颏角和胸骨 - 颈颏角距离有显著影响。乳突间缝合的添加对颈颏角影响最大，颈颏角的减小与胸骨 - 颈颏角距离的增加密切相关。低位舌骨的存在是与术后颈颏角显著减小相关的唯一术前因素。
