Mulliken J B, Ferraro N F, Vento A R
Division of Plastic Surgery, Children's Hospital, Boston, MA 02115.
Cleft Palate J. 1989 Oct;26(4):312-7.
A retrospective analysis of changes in costochondral rib grafts used to construct the condyle-ramus in children with hemifacial microsomia (HFM) was made. The mean age at surgical correction was 6.5 years, and the average follow-up was 4.5 years. Direct measurements were made on panoramic radiographs. The condyle-ramus length was expressed as a percentage change comparing the constructed with the normal side. During the first 2 postoperative years, there was either no change or a slight decrease in the length of the rib graft. After 2 years, however, the costochondral graft elongated at a slow, irregular rate. The mode change was 11 percent over the postoperative study period. In four patients who exhibited rapid growth of the normal condyleramus (greater than the mean change of 0.94 cm), the constructed side failed to keep pace. In another group of four patients who exhibited moderate elongation of the normal side, the grafted side grew commensurately or demonstrated greater than normal percentage change in length. There was no correlation between the initial size of the costochondral graft, age at time of operation, or presenting type of mandibular deformity. These findings are discussed in terms of the intrinsic growth and the functional matrix theories of mandibular development.
对用于构建半侧颜面短小畸形（HFM）患儿髁突-升支的肋软骨移植变化进行了回顾性分析。手术矫正时的平均年龄为6.5岁，平均随访时间为4.5年。在全景X线片上进行直接测量。髁突-升支长度以构建侧与正常侧相比的百分比变化表示。术后头两年，肋软骨移植的长度要么没有变化，要么略有缩短。然而，两年后，肋软骨移植以缓慢、不规则的速度延长。术后研究期间的模式变化为11%。在4例正常髁突-升支快速生长（大于平均变化0.94 cm）的患者中，构建侧未能跟上生长速度。在另一组4例正常侧中度延长的患者中，移植侧相应生长或长度变化百分比大于正常。肋软骨移植的初始大小、手术时年龄或下颌畸形的表现类型之间均无相关性。根据下颌骨发育的内在生长和功能基质理论对这些发现进行了讨论。
