Driemel O, Kloss F, Roth B, Würzler K K, Pistner H
Klinik für Mund-, Kiefer- und Gesichtschirurgie/Plastische Operationen, HELIOS Klinikum Erfurt.
Mund Kiefer Gesichtschir. 2004 Sep;8(5):289-95. doi: 10.1007/s10006-004-0554-8. Epub 2004 Jul 28.
Striving for beauty and expressiveness is a deeply rooted human attitude. The lower jaw-especially the mentum-plays an important role in the perception of the face as an instrument of communication. According to Grammer a distinctive lower jaw is an essential characteristic feature of male attractiveness.
During a period of 10 years 58 patients underwent genioplasty. A follow-up examination was performed in 49 patients (complete sensitivity evaluation: 33 patients, complete photoanalysis: 30 patients). To reduce radiation due to cephalometric radiography a simple photometric method for cephalometry was developed and applied. Particular attention was directed at sensitivity of the mental nerve after genioplasty.
To the best of our knowledge, this is the first time that photos of the right profile were compared with those of the left side. Unexpectedly, intraindividual differences dependent on the facial side (right and left) could be found in the relationship of the lower to the upper face and in the proportion of the profile angle and the nasomental angle. After three-dimensional genioplasty these differences were reduced and facial asymmetry was improved. Comparing the right with the left side the average difference of the nasomental angle was reduced from 2.5 degrees to 0.6 degrees on average. The profile angle was changed by genioplasty from 19 degrees on average to 15 degrees ("ideally" 10 degrees , the so-called upright face). According to Schwarz the ideal height of the mentum (stomion-menton) should amount to 66% of the total lower face. Especially by combined dorsal and cranial positioning of the mentum a reduction from 85 to 68% was achieved. Postoperatively 24 of 33 patients (73%) showed disturbances of the mental nerve. After at least 1 year following the operation, normal sensitivity of the lower lip and chin of both sides was evaluated by almost all of these patients (19 of 24 = 79%). Especially all patients having had only a single genioplasty recovered totally from a neurosensory deficit.
Genioplasty can be considered to be a reliable procedure to achieve harmony of the lower face.
追求美与表现力是一种根深蒂固的人类态度。下颌，尤其是颏部，在将面部视为交流工具的认知中起着重要作用。根据格拉默的观点，独特的下颌是男性魅力的一个基本特征。
在10年期间，58例患者接受了颏成形术。对49例患者进行了随访检查（完全敏感性评估：33例患者，完全照片分析：30例患者）。为减少头颅侧位片的辐射，开发并应用了一种简单的光度学头颅测量方法。特别关注颏成形术后颏神经的敏感性。
据我们所知，这是首次将右侧面部照片与左侧面部照片进行比较。出乎意料的是，在下面部与上面部的关系以及侧面轮廓角和鼻颏角的比例方面，发现了个体内依赖于面部侧别（右侧和左侧）的差异。三维颏成形术后，这些差异减小，面部不对称得到改善。比较左右两侧，鼻颏角的平均差异从2.5度平均减小到0.6度。颏成形术使侧面轮廓角从平均19度变为15度（“理想”为10度，即所谓的直面型）。根据施瓦茨的观点，颏部（口下点 - 颏下点）的理想高度应占整个下面部的66%。特别是通过颏部的联合背侧和颅侧定位，实现了从85%到68%的降低。术后33例患者中有24例（73%）出现颏神经功能障碍。术后至少1年，几乎所有这些患者（24例中的19例 = 79%）对双侧下唇和颏部的正常感觉进行了评估。特别是所有仅接受过一次颏成形术的患者均从神经感觉缺损中完全恢复。
颏成形术可被认为是实现下面部和谐的可靠手术。
