Tominaga K, Habu M, Iwanaga K, Kodama M, Tsurushima H, Kokuryo S, Miyamoto I, Fukudome Y, Yoshioka I
Division of Oral and Maxillofacial Surgery, Department of Science of Physical Function, Kyushu Dental University, Kitakyushu, Japan.
Division of Oral and Maxillofacial Surgery, Department of Science of Physical Function, Kyushu Dental University, Kitakyushu, Japan.
Int J Oral Maxillofac Surg. 2016 Feb;45(2):194-9. doi: 10.1016/j.ijom.2015.10.020. Epub 2015 Nov 16.
A modified technique of horseshoe osteotomy combined with Le Fort I osteotomy for superior and posterior repositioning of the maxilla is presented. Eight patients with maxillary excess associated with retrogenia or microgenia were treated with this technique in combination with genioplasty. The maxillary segment was repositioned a maximum of 5.0mm posteriorly and 7.0mm superiorly at point A. The mandible autorotated anterosuperiorly to achieve sound occlusion. Point B moved 2.0-10.0mm anteriorly and 5.0-10.0mm superiorly. The pogonion moved 7.0-17.0mm anteriorly in combination with genioplasty. All patients obtained sound occlusion and a good profile after the operation. Almost no skeletal relapse was observed during 1 year of postoperative follow-up. Patients with long faces with maxillary excess and retrogenia often have small, unstable condyles. In these cases, because surgical intervention to the ramus can result in postoperative progressive condylar resorption, maxillary single-jaw surgery with a horseshoe osteotomy, thereby avoiding ramus intervention, is a less invasive option.
本文介绍了一种改良的马蹄形截骨术联合勒福Ⅰ型截骨术，用于上颌骨的上后方向重新定位。8例伴有颏后缩或小颏畸形的上颌骨过度发育患者采用该技术联合颏成形术进行治疗。上颌骨段在A点最多向后重新定位5.0mm，向上重新定位7.0mm。下颌骨自动向前上方旋转以实现良好的咬合。B点向前移动2.0 - 10.0mm，向上移动5.0 - 10.0mm。联合颏成形术时，颏前点向前移动7.0 - 17.0mm。所有患者术后均获得良好的咬合和面部外形。术后1年随访期间几乎未观察到骨骼复发。长面型伴上颌骨过度发育和颏后缩的患者通常髁突较小且不稳定。在这些情况下，由于对下颌升支进行手术干预可能导致术后进行性髁突吸收，采用马蹄形截骨术的上颌单颌手术，从而避免对下颌升支进行干预，是一种侵入性较小的选择。
