Berrada K, Deffez J P, Allain P, Brethaux J, Gross D, Hazen M, Themar P
Service de Stomatologie et Chirurgie Maxillo-faciale Infantiles, Hôpital Robert Debré, Paris.
Rev Stomatol Chir Maxillofac. 1991;92(2):71-6.
The combination of --hypoplastic upper jaw, with narrow soft palate, --glossoptosis (or low, propulsive tongue), associated with protrusion of lower jaw, is well known. Early, exclusively orthopedic management combines enlargement of the superior arcade; functional/postural re-education of the tongue. Surgical management comes in later; it associates modeling resection of the tongue intended to position the tongue against the palate, with Chevron's mandibular resection, suppression of the first premolar, and salvaging the mental nerve. This type of osteotomy is indicated whenever a 6 to 8 mm mandibular retrusion is required. Fixation is monomaxillar, via extemporaneous splinting, associated with low external cortical osteosynthesis. The latter allows for gain of motor activity as early as the second day post-surgery.
发育不全的上颌骨合并狭窄的软腭、舌后坠(或低位、前推性舌)并伴有下颌前突,这种情况广为人知。早期单纯采用矫形治疗,包括扩大上颌牙弓;对舌进行功能/姿势再训练。后期进行手术治疗,包括对舌进行塑形切除以使舌抵住腭部,同时进行契形下颌骨切除术、拔除第一前磨牙并保留颏神经。每当需要下颌后缩6至8毫米时,就可采用这种截骨术。固定采用单颌固定,通过临时夹板固定,并结合低位外部皮质骨内固定。后者可使患者在术后第二天就能尽早恢复运动功能。