Lu Chuan, Xie Qianyang, He Dongmei, Yang Chi
Attending Surgeon, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China.
Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China.
J Oral Maxillofac Surg. 2020 Aug;78(8):1417.e1-1417.e14. doi: 10.1016/j.joms.2020.03.025. Epub 2020 Apr 2.
We evaluated the stability of orthognathic surgery in the treatment of unilateral condylar osteochondroma combined with jaw deformity.
Patients with unilateral condylar osteochondroma and jaw deviation deformity who had undergone surgery at the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from July 2014 to March 2017 were enrolled. The operation included a low condylectomy and both Le Fort I osteotomy and bilateral mandibular sagittal split osteotomies. ProPlan CMF, version 1.4, software (Materialise, Leuven, Belgium) was used to reconstruct and measure the preoperative, immediately postoperative, and follow-up (>6 months) maxillofacial computed tomography images. The position of the jaw and contralateral condyle and remodeling of the affected side were compared during follow-up.
Eight patients were included in the present study. The canting of the maxilla was significantly decreased postoperatively, and the contralateral condyle had rotated inward. The position of the maxillary and contralateral condyles was stable during follow-up, and the posterior aspect of the affected condyle demonstrated significant resorption.
The results of single-stage surgery combined with orthognathic surgery and condylar osteochondroma resection were stable, and the affected condyle stump had adaptively reconstructed.
我们评估了正颌手术治疗单侧髁突骨软骨瘤合并颌骨畸形的稳定性。
纳入2014年7月至2017年3月在上海交通大学医学院附属第九人民医院接受手术的单侧髁突骨软骨瘤合并颌骨偏斜畸形患者。手术包括低位髁突切除术以及Le Fort I型截骨术和双侧下颌矢状劈开截骨术。使用ProPlan CMF 1.4版软件（Materialise，比利时鲁汶）重建并测量术前、术后即刻及随访（>6个月）的颌面计算机断层扫描图像。随访期间比较颌骨和对侧髁突的位置以及患侧的重塑情况。
本研究纳入8例患者。术后上颌偏斜明显减轻，对侧髁突向内旋转。随访期间上颌和对侧髁突位置稳定，患侧髁突后部出现明显吸收。
一期手术联合正颌手术及髁突骨软骨瘤切除术的效果稳定，患侧髁突残端已适应性重建。
