Ma Fushun, Tang Shengjian
Plastic Surgery Hospital of Weifang Medical University, 288 Shenglidongjie Kuiwen, Weifang, 261042, Shandong, China,
Aesthetic Plast Surg. 2014 Dec;38(6):1143-50. doi: 10.1007/s00266-014-0405-4. Epub 2014 Oct 16.
The midfacial width is dominated by the lateral protruding degree of the zygomatic arch. The best way of narrowing the midface is to reduce the arch height and the arc length for patients with an overly curved lateral protruding zygomatic arch. The existing techniques for reduction malarplasty cannot change the degree of curvature of the zygomatic arch. We provide a new technique for efficient midfacial width reduction by multiple osteotomies at different sites on the zygomatic complex and bone resection at the most protruding middle part of the zygomatic arch. The amount of bone resection can be calculated with a simplified geometrical solution according to the desired reduction rate of the arch height.
A digitalized CT image was used to estimate the arch height and the length of bone for removal from the zygomatic arch. A specific piece of bone was removed from the most protruding point of each zygomatic arch. Greenstick fractures were made at the anterior and posterior roots of the zygomatic arch. The open arches were rotated inwardly until both ends met.
The arch heights of 1,020 sides of the zygomatic arch were reduced in a range from 3 to 11 mm. All the reduced zygomatic arches were reunited properly and healed solidly. The overall satisfaction rate was high.
This technique reduces the width of the midface by changing the degree of curvature of the zygomatic arch. The simplified geometrical calculation solutions are helpful in assuring the reunion of the zygomatic arch at a pre-designed lower arc height level after a calculated shortening of the arc length.
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面中部宽度主要由颧弓的外侧突出程度决定。对于外侧突出且过度弯曲的颧弓患者，缩小面中部的最佳方法是降低颧弓高度和弧长。现有的颧骨缩小成形术技术无法改变颧弓的弯曲程度。我们提供了一种新技术，通过在颧骨复合体的不同部位进行多处截骨以及在颧弓最突出的中部进行骨切除，来有效缩小面中部宽度。根据所需的颧弓高度降低率，可通过简化的几何解法计算骨切除量。
使用数字化CT图像来估计颧弓高度和需从颧弓切除的骨长度。从每个颧弓的最突出点切除特定的一块骨。在颧弓的前根和后根处造成青枝骨折。将张开的颧弓向内旋转直至两端相接。
1020侧颧弓的高度降低了3至11毫米。所有缩小后的颧弓均正确复位并牢固愈合。总体满意率较高。
该技术通过改变颧弓的弯曲程度来缩小面中部宽度。简化的几何计算方法有助于确保在计算出的弧长缩短后，颧弓能在预先设计的较低弧高度水平处重新愈合。
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