The Dutch Craniofacial Centre, Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center (Head of Department: Professor Eppo B. Wolvius), Sophia's Children's Hospital, Rotterdam, The Netherlands.
The Dutch Craniofacial Centre, Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center (Head of Department: Professor Eppo B. Wolvius), Sophia's Children's Hospital, Rotterdam, The Netherlands; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, USA.
J Craniomaxillofac Surg. 2018 Sep;46(9):1436-1440. doi: 10.1016/j.jcms.2018.05.044. Epub 2018 May 24.
Patients with Craniofacial Microsomia (CFM) mandibles Types I/IIa benefit from combined LeFort 1 osteotomy and Mandibular Distraction Osteogenesis (LeFort + MDO); Type IIb from LeFort + MDO or Bimaxillary osteotomy (BiMax); and Type III from BiMax (with 50% of cases having preceding mandibular procedures, including patient-fitted prosthesis); as seen in Part 1. This leads to the question how maxillary and mandibular hypoplasia are correlated and influence the types of maxillary correction.
A retrospective chart study was conducted including patients diagnosed with CFM from 2 large craniofacial units. Radiographic and clinical information were obtained. Unilateral affected patients with available (ConeBeam) CT-scan of the maxillary-mandibular complex, without treatment of the upper jaw prior to the CT-scan were included. A maxillary cant grading system was set up and evaluated. Pearson correlation coefficients were used to correlate the maxillary cant and the severity of the mandibular hypoplasia.
Eighty-one patients were included, of whom 39.5% had a Pruzansky-Kaban type III mandible and 42% a mild maxillary cant. There was a significant positive correlation between severity of the mandibular hypoplasia and the categorized canting (r = 0.370; p < 0.001; n = 81). Twenty-four patients had maxillary surgery, mainly a BiMax.
There is a positive correlation between the severity of mandibular hypoplasia and maxillary cant. The severity of mandibular hypoplasia seems to dictate an intervention for both maxillary and mandibular surgery.
颅面短小症（CFM）患者的下颌骨 I/IIa 型受益于 LeFort 1 截骨术和下颌骨牵引成骨术（LeFort + MDO）的联合治疗；IIb 型受益于 LeFort + MDO 或双颌骨切开术（BiMax）；III 型受益于 BiMax（50%的病例之前进行过下颌手术，包括患者适配的假体）；如第 1 部分所述。这就引出了一个问题，即上颌骨和下颌骨发育不全如何相关，以及如何影响上颌骨矫正的类型。
对 2 个大型颅面单位诊断为 CFM 的患者进行回顾性图表研究。获得了影像学和临床资料。纳入了单侧受累且上颌-下颌复合体有可利用（锥形束 CT）扫描的单侧患者，且在上颌 CT 扫描前未对上颌进行治疗。建立并评估了上颌前突分级系统。使用 Pearson 相关系数来关联上颌前突和下颌骨发育不全的严重程度。
共纳入 81 例患者，其中 39.5%有 Pruzansky-Kaban Ⅲ型下颌骨，42%有轻度上颌前突。下颌骨发育不全的严重程度与分类的前突程度呈显著正相关（r = 0.370；p < 0.001；n = 81）。24 例患者接受了上颌手术，主要是 BiMax。
下颌骨发育不全的严重程度与上颌前突呈正相关。下颌骨发育不全的严重程度似乎决定了上颌和下颌手术的干预。
