Tan Wuyuan, Niu Feng, Yu Bing, Gui Lai
Department of Cranio-Maxillofacial Surgery, Plastic Surgery Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
J Craniofac Surg. 2011 Mar;22(2):546-50. doi: 10.1097/SCS.0b013e318208bb41.
Reduction malarplasty with L-shaped osteotomy has been widely applied to correct malar prominence because of its simple manipulation, satisfactory outcome, and few complications in east Asians. Secondary surgery for the removal of titanium miniplates or microplates and screws is often needed because of the drawbacks of implants. To overcome the disadvantage, the authors applied absorbable plates and screws instead of titanium fixation system and evaluated the feasibility of them. A total of 47 women (mean age, 26.8 y) diagnosed with malar prominence were randomly selected and received L-shaped osteotomy for malar reduction from January 2008 to December 2009. Of these, 22 patients (group A) received absorbable plates and screws (Fixsorb-MX, Takiron, Japan) for fixation and 25 patients received titanium fixation system as control (group B). The outcomes were evaluated by photographs and x-ray films. The distance of the anterior protrusive point of the bilateral zygoma (Zv-Zv), the distance from the paries anterior of acoustic duct (P) to the anterior protrusive point of zygoma (P-Zv), and the angle formed by the nasion-Zv line and the P-Zv line (∠NZP) were analyzed through posteroanterior and lateral cephalograms preoperatively, 10 days postoperatively, and at 6 to 12 months of follow-up, respectively. In group A, 20 patients (90.9%) were satisfied with the outcomes compared with 92.0% in group B. No zygomatic nonunion and other complications occurred after surgery in both groups. In group A, the values of Zv-Zv and P-Zv were 88.4±1.6 and 68.6±6.8 mm at 10 days after surgery, which increased to 90.6±1.5 and 70.7±3.0 mm at 6 to 12 months of follow-up. The value of ∠NZP was 105.0±4.3 degrees at 10 days after surgery and 103.2±3.6 degrees at 6 to 12 months after surgery. In group B, the values of distance and degree maintained almost the same at different time points after surgery. The results had no significant difference between groups A and B (P>0.05). The findings of the study suggested that the application of absorbable plate system in reduction malarplasty with L-shaped osteotomy is feasible. The absorbable fixation system would have a wider application in craniofacial surgery.
L形截骨颧骨缩小术因其操作简单、效果满意且在东亚人群中并发症少，已被广泛应用于矫正颧骨突出。由于植入物的缺点，通常需要二次手术取出钛制微型板或微型螺钉及螺钉。为克服这一缺点，作者应用可吸收板和螺钉替代钛固定系统并评估其可行性。2008年1月至2009年12月，共随机选取47例诊断为颧骨突出的女性（平均年龄26.8岁），接受L形截骨颧骨缩小术。其中，22例患者（A组）接受可吸收板和螺钉（Fixsorb-MX，日本Takiron公司）固定，25例患者接受钛固定系统作为对照（B组）。通过照片和X线片评估结果。分别在术前、术后10天以及随访6至12个月时，通过正位和侧位头颅X线片分析双侧颧骨前突点（Zv-Zv）的距离、外耳道前壁（P）至颧骨前突点（P-Zv）的距离以及鼻根-Zv线与P-Zv线形成的角度（∠NZP）。A组中，20例患者（90.9%）对结果满意，B组为92.0%。两组术后均未发生颧骨不愈合及其他并发症。A组术后10天时Zv-Zv和P-Zv的值分别为88.4±1.
