Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Ba-Da-Chu Road, Shijingshan District, Beijing, China.
Aesthetic Plast Surg. 2019 Jun;43(3):733-741. doi: 10.1007/s00266-019-01364-y. Epub 2019 Apr 12.
Facial asymmetry combined with a prominent mandibular angle is common in the population. Its treatment involves two or three stages of surgeries. Generally, orthognathic surgery is a top priority. However, some patients with no severe occlusion disorders focus on the appearance and could not accept complex therapeutic procedures. This study evaluated the surgical effect of en bloc mandibular angle-body-chin curved ostectomy (MABCCO) combined with traditional mandibular angle curved ostectomy (MACO) and bilateral outer cortex grinding (OCG) to correct facial asymmetry and a prominent mandibular angle.
From September 2013 to November 2017, a total of 40 patients with facial asymmetry and prominent mandibular angle were chosen for this study. The authors performed single-stage surgery of en bloc MABCCO combined with traditional MACO and bilateral outer cortex grinding to correct facial asymmetry. Patient satisfaction was investigated by questionnaires at 6 months postoperation. The effectiveness was then evaluated through cephalometric radiographs, three-dimensional computed tomography, and preoperative and postoperative standard facial photographs.
The postoperative results of all 40 cases showed that facial asymmetry was effectively corrected without serious complications, and the square face was also significantly improved with a harmonious mandibular contour. There was a statistical difference between the patient's preoperative and postoperative satisfaction scores (p < 0.05). The objective esthetic outcomes evaluated by both surgeons and patients were quite satisfactory.
Single-stage surgery of en bloc MABCCO combined with traditional MACO and bilateral OCG was an adaptable option for correction of facial asymmetry and prominent mandibular angle with slight occlusion disorders, which can both largely shorten treatment time and shape a harmonious face.
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面部不对称伴下颌角突出在人群中较为常见。其治疗涉及两到三个阶段的手术。通常，正颌手术是首选。然而，一些无严重咬合紊乱的患者注重外观，无法接受复杂的治疗程序。本研究评估了整块下颌角体颏部曲骨切除术（MABCCO）联合传统下颌角曲骨切除术（MACO）和双侧外皮质磨除术（OCG）治疗面部不对称伴下颌角突出的手术效果。
2013 年 9 月至 2017 年 11 月，共 40 例面部不对称伴下颌角突出患者选择本研究。作者采用整块 MABCCO 联合传统 MACO 和双侧外皮质磨除术进行一期手术治疗，术后 6 个月通过问卷调查评估患者满意度，通过头颅侧位片、三维 CT 和术前术后标准面部照片评估疗效。
40 例患者术后结果均显示面部不对称得到有效矫正，无严重并发症，方脸也明显改善，下颌轮廓更加协调。患者术前和术后满意度评分差异有统计学意义（p < 0.05）。医生和患者对客观美学效果的评价都非常满意。
整块 MABCCO 联合传统 MACO 和双侧 OCG 的一期手术是治疗轻度咬合紊乱伴面部不对称和下颌角突出的一种可行选择，可大大缩短治疗时间，塑造和谐的面容。
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