Liu Hanghang, Zhang Xiaohui, Liu Li, Chen Qianming, Shao Jun, Luo En
West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, China.
Aesthetic Plast Surg. 2017 Jun;41(3):650-660. doi: 10.1007/s00266-017-0818-y. Epub 2017 Feb 23.
Hemifacial microsomia (HFM) is one of the most common congenital craniofacial asymmetries. Distraction osteogenesis (DO) is always recommended as an effective option for the treatment of HFM, but some studies showed that the asymmetry remained after DO. In comparison with DO, stable clinical outcomes could be achieved by orthognathic surgery approach as well. However, soft tissue expansion cannot be performed. In this study, we aim to assess the radiographic and clinical results of bimaxillary DO associated with staged orthognathic surgery in the treatment of craniofacial asymmetry for adult HFM patients.
Twelve HFM patients who had been treated with bimaxillary DO and secondary orthognathic surgery between 2006 and 2013 were included in this study. Bimaxillary DO and staged orthognathic surgery were performed according to the particular condition. Clinical and cephalometric photographs were carried out pre- and postoperatively to evaluate the outcomes.
No significant complications occurred postoperatively. Excellent cosmetic outcomes such as notable improvement in facial pattern and occlusion were achieved. Cephalometrically, the height ratios of the affected/unaffected ramus were improved by 23.81% on average, and the photographic analysis demonstrated a rotation of the chin point toward the mid-line. Moreover, the occlusal cant was corrected from the slant to level by 8.95° on average.
The application of bimaxillary DO associated with staged orthognathic surgery in correcting the asymmetry of adult patients with HFM could have satisfactory aesthetic results, and it should be considered an alternative option for these patients.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
半侧颜面短小畸形（HFM）是最常见的先天性颅面部不对称畸形之一。牵张成骨术（DO）一直被推荐为治疗HFM的有效方法，但一些研究表明，DO术后仍存在不对称。与DO相比，正颌手术方法也能取得稳定的临床效果。然而，无法进行软组织扩张。在本研究中，我们旨在评估双颌DO联合分期正颌手术治疗成年HFM患者颅面部不对称的影像学和临床效果。
本研究纳入了2006年至2013年间接受双颌DO和二期正颌手术治疗的12例HFM患者。根据具体情况进行双颌DO和分期正颌手术。术前和术后进行临床和头影测量摄影以评估结果。
术后未发生明显并发症。获得了良好的美容效果，如面部形态和咬合明显改善。头影测量显示，患侧/健侧下颌升支高度比平均提高了23.81%，摄影分析显示颏点向中线旋转。此外，咬合偏斜平均从倾斜矫正至水平8.95°。
双颌DO联合分期正颌手术应用于矫正成年HFM患者的不对称畸形可取得满意的美学效果，应被视为这些患者的替代选择。
证据水平IV：本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266。
