Tan Wuyuan, Yu Bing, Niu Feng, Gui Lai
Department of Plastic and Aesthetic Surgery, Xiangya Hospital of Central South University, Changsha, China.
J Craniofac Surg. 2012 Jan;23(1):94-7. doi: 10.1097/SCS.0b013e318240f94a.
Distraction osteogenesis (DO) has been popular to improve hypoplastic mandible in patients with hemifacial microsomia in craniofacial surgery. However, changes in width of the lower face after DO still lack in literatures. The aim of this pilot study was to evaluate cephalometric changes in width of the lower face at different time points after DO and to give an insight into the influence on facial contour. A total of 10 patients (8 males and 2 females) with hemifacial microsomia received DO of the mandibular body measured by posteroanterior cephalograms. Five landmarks (crista galli, latero-orbitale, gonion of the unaffected side, incisor point superior of the unaffected maxilla, incisor point inferior of the unaffected side of the mandible) were chosen for cephalometric analysis. Six distances from the soft tissue contour perpendicularly to the vertical reference line (through crista galli) were calculated through the incisor point superior of the unaffected maxilla, gonion of the unaffected side, incisor point inferior of the unaffected side of the mandible. Measurements were taken preoperatively and postoperatively on the day distraction started (time 1), at the end of distraction (time 2), and at the end of the consolidation period (time 3). Calculations for statistical significance were done for all patients. Mean differences between 3 periods were measured by repeated-measures analysis with significance determined at the 0.05 level of confidence. The results suggested that the values of 6 distances at times 2 and 3 had no significant differences when compared with the values at time 1 (P>0.05). In conclusion, DO of the unilateral mandibular body in patients with hemifacial microsomia should not be beneficial to improve the width of the lower face at a short-term follow-up.
牵张成骨术（DO）在颅面外科中已广泛应用于改善半侧颜面短小畸形患者的发育不全下颌骨。然而，关于牵张成骨术后下脸宽度变化的文献报道仍较少。本初步研究的目的是评估牵张成骨术后不同时间点下脸宽度的头影测量变化，并深入了解其对面部轮廓的影响。共有10例半侧颜面短小畸形患者（8例男性，2例女性）接受了下颌体的牵张成骨术，通过正位头影测量片进行测量。选择五个标志点（鸡冠点、眶外侧点、健侧下颌角点、健侧上颌切牙点、健侧下颌切牙点）进行头影测量分析。通过健侧上颌切牙点、健侧下颌角点、健侧下颌切牙点，计算从软组织轮廓垂直于垂直参考线（通过鸡冠点）的六个距离。在术前、牵张开始当天（时间1）、牵张结束时（时间2）和巩固期结束时（时间3）进行测量。对所有患者进行统计学显著性计算。通过重复测量分析测量三个时期之间的平均差异，显著性水平设定为0.05。结果表明，时间2和时间3时六个距离的值与时间1时的值相比无显著差异（P>0.05）。总之，在短期随访中，半侧颜面短小畸形患者单侧下颌体的牵张成骨术对改善下脸宽度并无益处。
