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肋软骨移植用于小儿半侧颜面短小畸形

Costochondral Graft in Young Children With Hemifacial Microsomia.

作者信息

Wu Bin-Zhang, Ma Lian, Li Yang, Chen Shuo, Yi Biao

机构信息

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China.

出版信息

J Craniofac Surg. 2017 Jan;28(1):129-133. doi: 10.1097/SCS.0000000000003268.

Abstract

Patients with severely hypoplastic mandibles usually require condylar reconstruction. This study aimed to describe costochondral graft (CCG) for condylar reconstruction and report subsequent outcomes of these grafts in young children with Pruzansky/Kaban type IIB and type III mandibular hypoplasia. This study included 4 young children with type IIB and type III hemifacial microsomia treated with CCG to reconstruct the condyle at the Department of Oral and Maxillofacial Surgery in our hospital from March 2008 to March 2014. Radiographic measurements and clinical examinations were conducted. The mean age of patients at operation was 3.8 years, ranging from 2.8 to 5.3 years. The mean follow-up period was 43.5 months, ranging from 23 to 63 months. Functional improvement was observed in all patients. The ribs had grown in all patients to date. Three patients had clinically improved face appearance with no significant chin point deviation and canting of the occlusal plane. Although the other patient had partly improved face appearance compared with preoperative condition, he still showed clinically significant facial asymmetry and chin deviation. Our results showed that condylar reconstruction with CCG is a feasible method in the treatment of type IIB and type III hemifacial microsomia in young children. These results will provide early preliminary suggestions of growth and stability of CCG in patients <5 years.

摘要

严重下颌骨发育不全的患者通常需要进行髁突重建。本研究旨在描述肋软骨移植(CCG)用于髁突重建,并报告这些移植在患有普鲁赞斯基/卡班IIB型和III型下颌骨发育不全的幼儿中的后续结果。本研究纳入了2008年3月至2014年3月在我院口腔颌面外科接受CCG治疗以重建髁突的4例IIB型和III型半侧颜面短小畸形的幼儿。进行了影像学测量和临床检查。患者手术时的平均年龄为3.8岁,范围在2.8至5.3岁之间。平均随访期为43.5个月,范围在23至63个月之间。所有患者均观察到功能改善。迄今为止,所有患者的肋骨均已生长。3例患者的面部外观在临床上得到改善,无明显的颏点偏斜和咬合平面倾斜。尽管另1例患者与术前相比面部外观有所改善,但仍表现出临床上明显的面部不对称和颏部偏斜。我们的结果表明,CCG髁突重建是治疗幼儿IIB型和III型半侧颜面短小畸形的一种可行方法。这些结果将为5岁以下患者CCG的生长和稳定性提供早期初步建议。

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