Kawakami Masayoshi, Yamamoto Kazuhiko, Noshi Toshiaki, Miyawaki Shoichi, Kirita Tadaaki
Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
J Oral Maxillofac Surg. 2004 Oct;62(10):1188-92. doi: 10.1016/j.joms.2004.06.032.
The objective of this study was to examine the effect of partial glossectomy on skeletal stability and postoperative changes after mandibular setback.
Sagittal split ramus osteotomy with semirigid fixation was performed in 21 patients with tongue reduction surgery (tongue reduction group) and was performed in 19 patients without tongue reduction (control group). Lateral cephalograms were evaluated preoperatively, immediately postoperatively, and 1 year postoperatively, to analyze the maxillomandibular relation and soft tissue morphology.
The results in both groups suggested that posterior and downward movement of the hyoid bone and narrowing of the upper pharyngeal airway at the tongue base were evident immediately postoperatively and rebounded to their original position 1 year after surgery. The tongue reduction had an effect to prevent narrowing of the posterior airway space and a tendency to reduce clockwise rotation of the mandible after the setback, but there was no significant difference between the 2 groups in the horizontal and vertical changes of incisal position at 1 year.
Adaptation of the hyoid bone position and tongue mass to the altered environment after setback surgery may preclude the necessity for downsizing the tongue against the relapse in patients with normal tongue morphology.
本研究的目的是探讨部分舌切除术对下颌后缩术后骨骼稳定性及术后变化的影响。
对21例行舌缩小术的患者(舌缩小组)和19例未行舌缩小术的患者(对照组)进行了下颌升支矢状劈开截骨术并采用半刚性固定。术前、术后即刻及术后1年对头颅侧位片进行评估,以分析颌骨关系及软组织形态。
两组结果均显示,术后即刻舌骨向后下方移动及舌根处上咽气道变窄明显,术后1年反弹至原始位置。舌缩小术有防止后气道间隙变窄的作用,且有减少下颌后缩后顺时针旋转的趋势,但两组术后1年切牙位置的水平和垂直变化无显著差异。
对于舌形态正常的患者,舌骨位置和舌体质量对下颌后缩手术后改变的环境的适应,可能排除了为防止复发而缩小舌体的必要性。