Mehrotra Divya, Howladar Debraj, Bhutia Dichen P
Dept. of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Oral Biol Craniofac Res. 2017 May-Aug;7(2):147-152. doi: 10.1016/j.jobcr.2017.04.009. Epub 2017 May 7.
The goal in treating Hemifacial microsomia (HFM) is to improve facial symmetry, allow functional jaw movement, obtain stable occlusion, and achieve patient satisfaction. This study was planned with an aim to assess the outcome of simultaneous maxillomandibular distraction osteogenesis in hemifacial microsomia.
MATERIAL & METHODS: Seven patients with hemifacial microsomia were included in this study and demographic data was obtained. Simultaneous maxillo-mandibular distraction was planned for correction of maxillary cant, vertical ramal lengthening and midline, by performing unilateral mandibular osteotomy in ramus and distractor fixation, a Le Fort I osteotomy, with fixation at contralateral zygomatic buttress and intermaxillary elastics. Derriford Appearance Scale was used to measure individual responses to address problems of appearance.
6 males and 1 female, with age range 18-26 years, mean 22.14 were included in the study. Maxillary occlusal cant varied from 4-16°, mean 9.85° and distraction achieved ranged from 12-19 mm, mean 15.57. Preoperatively DAS score ranged from 42-61, mean 51.7 and improved to 10-27, mean 18.4. 100% success was achieved in 5 cases, while other two showed 96% and 99% success.
Simultaneous maxillomandibular distraction osteogenesis improves facial esthetics and obviates the need for postoperative orthodontics, minimizing the treatment period.
治疗半侧颜面短小畸形（HFM）的目标是改善面部对称性、实现功能性颌骨运动、获得稳定的咬合以及让患者满意。本研究旨在评估半侧颜面短小畸形患者同时进行上颌下颌牵张成骨术的效果。
本研究纳入了7例半侧颜面短小畸形患者，并获取了人口统计学数据。计划通过在升支进行单侧下颌骨截骨术并固定牵张器、进行Le Fort I截骨术、在对侧颧弓支柱处固定以及使用颌间弹力牵引来同时进行上颌下颌牵张，以矫正上颌倾斜、垂直升支延长和中线问题。使用德里福德外貌量表来衡量个体对外貌问题的反应。
本研究纳入了6名男性和1名女性，年龄范围为18至26岁，平均年龄22.14岁。上颌咬合倾斜度在4°至16°之间，平均为9.85°，牵张距离在12毫米至19毫米之间，平均为15.57毫米。术前德里福德外貌量表评分为42至61分，平均为51.7分，术后改善至10至27分，平均为18.4分。5例患者成功率达到100%，另外两例分别为96%和99%。
上颌下颌同时牵张成骨术可改善面部美观，无需术后正畸治疗，缩短了治疗周期。
