Lee Sae Bin, Lee Jun Hyuk, Min Hyun Jin
Unique Aesthetic Clinic, Seoul, South Korea.
Department of Otorhinolaryngology - Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea.
J Craniomaxillofac Surg. 2016 Jul;44(7):783-8. doi: 10.1016/j.jcms.2016.04.019. Epub 2016 Apr 22.
Although the Gillies (temporal) approach to reduction malarplasty helps preserve supportive soft tissue and avoid facial scars, the osteotomy site is difficult to gauge when using this blind technique. Our experience with external radiopaque marking of the zygomatic arch to guide this process is presented herein. This retrospective review included all patients who underwent reduction malarplasty (as above) at our clinic between August 2013 and September 2015. Procedures entailed L-shaped osteotomy only (no segmental excision) of the zygomatic body by the intraoral route, and posterior zygomatic arch osteotomy by the Gillies approach, guided by external radiopaque markings. Patient characteristics, surgical outcomes, and complications were analyzed to assess the merits of this strategy. Postoperative results were evaluated by both the patients and the surgeon. Most patients expressed satisfaction during the follow-up period (range, 3-27 months). Posterior osteotomies were properly performed as planned, with no major complications (i.e., malunion or nonunion, cheek drooping, or facial nerve injury), although minor complications were recorded in three instances. Use of external radiopaque markings provides guidance during malarplasty by the Gillies approach and may help avoid procedural complications.
尽管吉利斯（颞部）入路进行颧骨缩小整形术有助于保留支持性软组织并避免面部瘢痕，但采用这种盲视技术时，截骨部位难以精确确定。本文介绍了我们使用外部不透射线标记颧弓来指导这一过程的经验。这项回顾性研究纳入了2013年8月至2015年9月期间在我们诊所接受颧骨缩小整形术（如上所述）的所有患者。手术采用经口入路仅对颧体进行L形截骨（无节段性切除），并通过吉利斯入路在外部不透射线标记的引导下对颧弓后部进行截骨。分析患者特征、手术结果和并发症，以评估该策略的优点。术后结果由患者和外科医生共同评估。大多数患者在随访期间（3至27个月）表示满意。后部截骨按计划顺利完成，未出现重大并发症（即骨不连或骨愈合不良、脸颊下垂或面神经损伤），不过有3例记录了轻微并发症。使用外部不透射线标记可为吉利斯入路的颧骨整形术提供指导，并可能有助于避免手术并发症。
