Fu Xi, Rui Lu, Liu JianFeng, Hirche Christoph, Niu Feng, Chen Ying, Wang Meng, Su RuoWei, Xu Jia, Gui Lai
From the *Department of CranioMaxilloFacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; †State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and ‡Department of Hand, Plastic, and Reconstructive Surgery, Trauma Centre Ludwigshafen, Ludwigshafen, Germany; and §Department of Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany.
J Craniofac Surg. 2014 Jul;25(4):1309-12. doi: 10.1097/SCS.0000000000000776.
Many plastic surgeons use mandibular osteotomy (reduction gonioplasty) without masseter resection to correct a square face. However, there is not enough long-term observation of the masseter after reduction gonioplasty, although some researches have already confirmed that the volume of masseter muscle does decrease shortly after reduction gonioplasty.
The Plastic Surgery Hospital database was retrospectively reviewed for patients who underwent reduction gonioplasty. Fifty-six patients with both preoperative and 4 years postoperative 3-dimensional computed tomography (3DCT) were included. The changes in the volume and morphology of the masseter muscle after reduction gonioplasty were assessed quantitatively. The 3DCT data were analyzed using Mimics 10.01 software.
All patients were satisfied with the outcome. No complications happened. There were significant differences between the preoperative and 4 years postoperative volume and morphology.
After reduction gonioplasty, the masseter muscle atrophied (reduced 20.98% ± 8.75%), especially the lower part of the masseter muscle in the long-term follow-up. Most patients with prominent mandibular angles should be treated with reduction gonioplasty without approaching the masseter muscle.
许多整形外科医生在不切除咬肌的情况下使用下颌骨截骨术（缩窄下颌角成形术）来矫正方形脸。然而，尽管一些研究已经证实缩窄下颌角成形术后咬肌体积确实会在短期内减小，但对缩窄下颌角成形术后咬肌的长期观察还不够。
对整形外科医院数据库中接受缩窄下颌角成形术的患者进行回顾性研究。纳入56例术前和术后4年均有三维计算机断层扫描（3DCT）的患者。定量评估缩窄下颌角成形术后咬肌体积和形态的变化。使用Mimics 10.01软件分析3DCT数据。
所有患者对结果满意。未发生并发症。术前和术后4年的体积和形态存在显著差异。
缩窄下颌角成形术后，咬肌萎缩（减少20.98%±8.75%），尤其是在长期随访中咬肌的下部。大多数下颌角突出的患者应采用缩窄下颌角成形术治疗，而无需触及咬肌。
