Verzé Laura, Bianchi Francesca Antonella, Schellino Eleonora, Ramieri Guglielmo
Department of Anatomy, Pharmacology and Legal Medicine, University of Turin, Turin, Italy.
J Craniofac Surg. 2012 Sep;23(5):1448-52. doi: 10.1097/SCS.0b013e31824e25fc.
Aesthetic improvement is an essential goal of treatment of facial asymmetry, and it is often difficult to achieve. Reliable three-dimensional measurements are required to support outcome studies. In this study, 15 white adult subjects, 9 females and 6 males, with maxillomandibular asymmetry and malocclusion were studied. The patients were treated with orthodontics and different surgical procedures in single or multiple steps. All patients received double-jaw surgery, except 1 patient who underwent only maxillary osteotomy. Nine of the 15 patients received additional procedures (genioplasty and rhinoplasty) to achieve better symmetry. Posterior-anterior and lateral cephalometry and three-dimensional facial surface data were obtained before (T0) and 1 year (T1) after surgery. Scan data at T0 and T1 were pooled by electronic surface averaging to obtain the mean pretreatment and posttreatment facial model. A symmetric model was constructed by averaging the actual T0 scans and their mirrored models to obtain the virtual optimal symmetric face. Different linear and angular measurements were then calculated for comparison of the mean T0 and T1 models. The normalization of facial proportion and a high increase in symmetry were evident. Residual defects were documented in the postoperative symmetry of the chin. Treatment of facial asymmetry, combined with dental occlusion problems, is still a challenge for maxillofacial surgeons. Orthognathic surgery provides an important improvement of symmetry, but further refinements of technique are still required. Three-dimensional evaluation results in an effective method to support outcome studies on the surgical correction of complex facial deformities.
美观改善是面部不对称治疗的一个重要目标，而这一目标往往难以实现。需要可靠的三维测量来支持疗效研究。在本研究中，对15名患有颌骨不对称和错牙合畸形的成年白人受试者进行了研究，其中9名女性，6名男性。患者接受了正畸治疗以及单步或多步不同的外科手术。除1名仅接受上颌截骨术的患者外，所有患者均接受了双颌手术。15名患者中有9名接受了额外的手术（颏成形术和鼻成形术）以实现更好的对称性。在手术前（T0）和手术后1年（T1）获取了正位和侧位头影测量数据以及三维面部表面数据。通过电子表面平均法将T0和T1时的扫描数据合并，以获得术前和术后的平均面部模型。通过将实际的T0扫描数据与其镜像模型平均来构建对称模型，以获得虚拟的最佳对称面部。然后计算不同的线性和角度测量值，以比较平均T0和T1模型。面部比例的正常化和对称性的大幅提高是显而易见的。术后颏部对称性存在残余缺陷。面部不对称与牙合问题相结合的治疗，仍然是颌面外科医生面临的一项挑战。正颌手术在对称性方面有重要改善，但仍需要进一步完善技术。三维评估为支持复杂面部畸形手术矫正的疗效研究提供了一种有效方法。
