Koba Akihiro, Tanoue Ryuichiro, Kikuta Shogo, Hirashima Shingo, Miyazono Yoshihiro, Kusukawa Jingo
Dental and Oral Medical Center, Kurume University School of Medicine.
Kurume Med J. 2018 Apr 27;64(3):57-63. doi: 10.2739/kurumemedj.MS643002. Epub 2018 Mar 16.
Mandibular osteotomy carries with it a risk of damaging blood vessels and nerves when using traditional surgical techniques. Piezosurgery, is a new technique that uses ultrasonic vibration to enable bone-selective sectioning without damage to the surrounding soft tissues. However, paralysis may not be completely eliminated using Piezosurgery for osteotomy. We investigated how piezoelectric surgery in bilateral sagittal splitting ramus osteotomy (BSSRO) affected the surrounding soft tissue. Forty-four patients with skeletal mandibular prognathism underwent mandibular setback with BSSRO. Patients were divided into two groups, those treated by the conventional chisel technique and those treated by Piezosurgery. Osteotomy time, blood loss, and incidence of paresthesia were compared retrospectively. Osteotomy time and blood loss in the piezo group were significantly reduced compared to the chisel group. Interestingly, whereas paresthesia incidence immediately after the operation did not differ between the groups, paresthesia in the piezo group 3 months postoperatively was significantly less than in the chisel group. However, a few cases of paralysis did not recover even in the piezo group. Blood loss and osteotomy time did not correlate with the paralysis. This study demonstrates that while piezoelectric surgery does impact the nerve tissue, the use of piezoelectric surgery in BSSRO leads to significantly less long term paralysis compared to surgery done by chisel.
使用传统手术技术进行下颌骨截骨术存在损伤血管和神经的风险。压电手术是一种新技术，它利用超声振动实现骨选择性切割，而不会损伤周围软组织。然而，使用压电手术进行截骨术可能无法完全消除麻痹。我们研究了双侧矢状劈开下颌支截骨术（BSSRO）中的压电手术如何影响周围软组织。44例下颌骨前突患者接受了BSSRO下颌后缩手术。患者分为两组，一组采用传统凿骨技术治疗，另一组采用压电手术治疗。对截骨时间、失血量和感觉异常发生率进行回顾性比较。与凿骨组相比，压电组的截骨时间和失血量显著减少。有趣的是，虽然术后即刻两组的感觉异常发生率没有差异，但压电组术后3个月的感觉异常明显少于凿骨组。然而，即使在压电组中也有少数麻痹病例没有恢复。失血量和截骨时间与麻痹无关。这项研究表明，虽然压电手术确实会影响神经组织，但与凿骨手术相比，在BSSRO中使用压电手术导致的长期麻痹明显更少。
