Andrade Neelam N, Aggarwal N, Mathai Paul, Nerurkar S
Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Dr. A.L.Nair Road, Opp. Maratha Mandir, Mumbai Central, Mumbai, 400008, India.
Oral Maxillofac Surg. 2018 Dec;22(4):463-474. doi: 10.1007/s10006-018-0714-x. Epub 2018 Sep 10.
Unilateral or bilateral ankylosis can lead to severe micrognathia and facial deformity that requires multiple, often, staged surgical corrections. To date, there is no ideal treatment modality that satisfactorily corrects the complex anatomy, restores the ramal height, and corrects the micrognathia and microgenia. Distraction osteogenesis has been acclaimed as a successful modality for the treatment of such deformities. It is a cost-effective approach with low morbidity and less relapse thus providing better functional and esthetic outcomes. It allows the surgeon to correct the deformity in various planes by using various devices by changing osteotomy designs and vectors, with simultaneous hard tissue and soft tissue reconstruction.
Here, we present a series of five cases where different types of distraction osteogenesis were combined with various other procedures to correct post-ankylotic facial asymmetry. In one case, simultaneous maxillo-mandibular distraction [Molina's technique] was used.
All patients showed significant improvement in function and esthetics. Outcome assessment was made using clinical photographs and radiographs.
Pre-arthroplastic distraction osteogenesis is a versatile cost effective approach that can be customized for every patient based on their needs.
单侧或双侧关节强直可导致严重的小颌畸形和面部畸形，这需要多次、通常是分阶段的手术矫正。迄今为止，尚无理想的治疗方式能够令人满意地矫正复杂的解剖结构、恢复升支高度并矫正小颌畸形和小颏畸形。牵引成骨术被誉为治疗此类畸形的成功方式。它是一种经济有效的方法，发病率低且复发少，从而能提供更好的功能和美学效果。它允许外科医生通过改变截骨设计和矢量，使用各种装置在不同平面矫正畸形，同时进行硬组织和软组织重建。
在此，我们呈现一系列5例病例，其中不同类型的牵引成骨术与各种其他手术相结合，以矫正关节强直后的面部不对称。在1例病例中，采用了同期上颌 - 下颌牵引术（莫利纳技术）。
所有患者在功能和美学方面均有显著改善。使用临床照片和X线片进行结果评估。
关节成形术前牵引成骨术是一种通用的、经济有效的方法，可根据每位患者的需求进行定制。
