Kim Sung Chan, Kwon Jin Geun, Jeong Woo Shik, Na Diane, Choi Jong Woo
Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Craniofac Surg. 2018 Jul;29(5):1161-1168. doi: 10.1097/SCS.0000000000004458.
Recently, the mandibular body and chin shape are known to be important issue as well as the mandibular angle. The authors have performed the one-piece mandibuloplasty from the mandibular angle to the most anterior part of chin to achieve the change of the whole mandibular shape as a one-piece.
All of 14 patients who complaint prominent mandibular angle and chin were randomly allocated into 2 groups. Group I (n = 7) was treated with conventional mandibuloplasty with narrowing genioplasty and Group II (n = 7) was treated with one-piece mandibuloplasty. Pre- and postoperative clinical photography, cephalometry, computed tomography scan, 3-dimensional photography were taken and occurrence of secondary angle, patient's satisfaction, and operative time were evaluated.
The mean volume reduction per side was 41.8 cc on one-piece mandibuloplasty and 36.5 cc on conventional mandibuloplasty with narrowing genioplasty. Furthermore, average lower facial decreased from 64.3 to 61.0 after 6 months postoperatively and was maintained until 3 years on average after the operation. In one-piece mandibuloplasty group shows a little higher satisfaction about mandible body, and it was estimated that the presence of secondary angle makes dissatisfaction. The authors' treatment approach resulted in a shorter total surgery time than conventional technique (70.57 versus 105.14 min, P = 0.002).
One-piece mandibuloplasty based on 3-dimensional printing model turned out to be very successful for the natural shaping of the lower jaw in the patients with the prominent mandible in terms of the technical efficiency and the aesthetic point of view.
近来,下颌体和下巴形状与下颌角一样,都被认为是重要问题。作者已实施从下颌角到下巴最前部的整块下颌骨整形术,以实现整体下颌形状的整块改变。
14例主诉下颌角和下巴突出的患者被随机分为2组。I组(n = 7)采用传统下颌骨整形术联合缩窄颏成形术治疗,II组(n = 7)采用整块下颌骨整形术治疗。术前后均进行临床摄影、头影测量、计算机断层扫描、三维摄影,并评估继发角的发生情况、患者满意度和手术时间。
整块下颌骨整形术每侧平均体积减少41.8 cc,传统下颌骨整形术联合缩窄颏成形术每侧平均体积减少36.5 cc。此外,术后6个月时平均面下1/3高度从64.3降至61.0,并在术后平均3年内保持稳定。整块下颌骨整形术组对下颌体的满意度略高,据估计继发角的存在会导致不满意。作者的治疗方法导致总手术时间比传统技术短(70.57对105.14分钟,P = 0.002)。
从技术效率和美学角度来看,基于三维打印模型的整块下颌骨整形术对于下颌突出患者的下颌自然塑形非常成功。