Gadre Kiran Shrikrishna, Halli Rajshekhar, Shah Shishir, Ramanojam Shandilya
Department of OMFS, Bharati Vidyapeeth University, Dental College and Hospital, Katraj Pune, India.
J Craniofac Surg. 2011 Jan;22(1):233-7. doi: 10.1097/SCS.0b013e3181f7b691.
It has been the desire and a great challenge to clinicians treating maxillofacial deformities to bring about symmetry in asymmetric faces. As one understands, it is very difficult to reproduce nature, that is, the normal side out of abnormal side, and it is easier to manage bilateral symmetrical deformities. Temporomandibular joint (TMJ) ankylosis, when it occurs in early childhood, will have devastating effects on the future growth and development of the jaws and teeth with obvious facial deformity including the chin, which worsens with advancing age and the time elapsed between the onset of ankylosis and the treatment instituted. We have been treating these chin deformities in adult unilateral TMJ ankylosis cases for over more than a decade with horizontal flip pedicled genioplasty, which has a mathematical basis of turning a scalene triangle to an isosceles triangle and thereby achieving symmetry. Fixation of the genial segment in an overriding position not only adds to the length of mandible but also overcomes the obstructive sleep apnea many times associated with TMJ ankylosis. We have successfully treated 15 patients using horizontal flip pedicled genioplasty during last 14 years. This instantaneous corrective and unique technique requiring minimal patient compliance is put forward with refinements developed during a period of years.
对于治疗颌面部畸形的临床医生来说，使不对称的面部恢复对称一直是他们的愿望和巨大挑战。众所周知，要复制自然状态，也就是从异常的一侧重现正常的一侧是非常困难的，而处理双侧对称性畸形则相对容易。颞下颌关节（TMJ）强直如果发生在儿童早期，会对颌骨和牙齿的未来生长发育产生毁灭性影响，导致明显的面部畸形，包括下巴畸形，且随着年龄增长以及强直发作与开始治疗之间时间的推移，畸形会愈发严重。在过去十多年里，我们一直采用水平翻转带蒂颏成形术治疗成人单侧TMJ强直病例中的这些下巴畸形，该手术有将不等边三角形转变为等腰三角形从而实现对称的数学原理。将颏部节段固定在覆盖位置不仅增加了下颌骨的长度，还多次克服了与TMJ强直相关的阻塞性睡眠呼吸暂停问题。在过去14年中，我们已成功使用水平翻转带蒂颏成形术治疗了15例患者。经过多年改进，我们提出了这种即时矫正且独特的技术，该技术对患者的依从性要求极低。
