Wu Guo-ping, Teng Li, Gui Lai, Sun Xiao-mei, Zhang Zhi-yong, Liu Jian-feng, Yu Bing, Xia De-lin, Luo Jin-chao
Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100041, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2006 Jan;22(1):18-21.
To investigate the causes and the prophylactic for the complications following mandibular distraction osteogenesis using internal distractors.
From 1997 to 2004, a total of 46 patients (61 sides) suffering from malformations or defects of mandible who underwent mandibular distraction osteogenesis were analyzed. The diseases included hemifacial microsomia in 27 cases, congenital or acquired mandibular hypoplasia and micrognathia bilateral in 8 cases and unilateral in 4 cases, electronical injury or postoperative mandibular defects in 3 cases, Treacher Collins syndrome in 2 cases, obstructive sleep apnea syndrome in 2 cases.
Of them, 9 patients had postoperative complications, which included 3 patients had complications associated with distractors, local infection occurred in 2 cases, apertognathia of anterior teeth in 2 case, 2 patients had sinus of the skin of the lower lip. 9 patients had been aggressivly managed and obtained satisfactory results.
The pivotal points to reduce complications are to understand the mechanism of mandibular distraction osteogenesis completely, and to be familiar with the anatomy of mandible and adjacent tissues. It is necessary to treat with it preoperatively and postoperatively.
探讨使用内置式牵引器进行下颌骨牵张成骨术后并发症的原因及预防措施。
对1997年至2004年期间共46例（61侧）接受下颌骨牵张成骨术治疗下颌骨畸形或缺损的患者进行分析。疾病包括半侧颜面短小畸形27例，先天性或后天性下颌骨发育不全及小颌畸形双侧8例、单侧4例，电击伤或术后下颌骨缺损3例，特雷彻·柯林斯综合征2例，阻塞性睡眠呼吸暂停综合征2例。
其中9例患者出现术后并发症，包括3例与牵引器相关的并发症，局部感染2例，前牙开合2例，下唇皮肤窦道2例。对9例患者进行积极处理，取得满意效果。
减少并发症的关键在于全面了解下颌骨牵张成骨的机制，熟悉下颌骨及相邻组织的解剖结构，术前术后均需进行相应处理。
