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矫正半侧下颌骨增生导致的面部不对称:实现美学效果的手术步骤

Correction of facial asymmetry resulting from hemimandibular hyperplasia: surgical steps to the esthetic result.

作者信息

Avelar Rafael Linard, Becker Otávio Emmel, Dolzan André do Nascimento, Göelzer Juliana Gonçalves, Haas Orion Luiz, de Oliveira Rogério Belle

机构信息

Department of Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul, Brazil.

出版信息

J Craniofac Surg. 2012 Nov;23(6):1898-900. doi: 10.1097/SCS.0b013e318266f76b.

Abstract

Hemimandibular hyperplasia is a facial deformity in which there is an increase in the condyle, neck of the condyle or ramus, and an occlusal cant. Different surgical treatments are proposed in the literature, from simple low or high condylectomy to more complex procedures combining osteotomies in different sites of the mandible. Surgical procedure is defined by the scintigraphic diagnosis of activity or inactivity in the center of condylar growth. The case report describes a 35-year-old female patient with hemimandibular hyperplasia on the left side with inactivity of condylar growth, successfully treated with bilateral sagittal split ramus osteotomy associated with a basilar osteotomy in form of "L" on the affected side. The surgical technique was easily executed, with an improvement in function, aesthetics, and patient satisfaction. Correction of facial asymmetry caused by excessive growth of the mandible using this basilar osteotomy in the form of "L" combined with bilateral sagittal split ramus osteotomy proved to be a relatively simple technique of easy execution with a low risk of nerve damage.

摘要

半侧下颌骨增生是一种面部畸形,表现为髁突、髁突颈部或下颌支增大,并伴有咬合偏斜。文献中提出了不同的外科治疗方法,从简单的低位或高位髁突切除术到在下颌骨不同部位联合截骨术的更复杂手术。手术方案根据髁突生长中心的闪烁扫描诊断结果确定为活跃或不活跃。该病例报告描述了一名35岁左侧半侧下颌骨增生且髁突生长不活跃的女性患者,通过双侧矢状劈开下颌支截骨术联合患侧“L”形基底截骨术成功治疗。该手术技术操作简便,功能、美观及患者满意度均有改善。采用这种 “L ”形基底截骨术联合双侧矢状劈开下颌支截骨术矫正下颌骨过度生长所致面部不对称,是一种操作相对简单、易于实施且神经损伤风险低的技术。

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