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三维分析下颌髁突结构与半侧颜面短小畸形伴发外耳畸形的相关性。

Correlations Between Mandible Condylar Structures and External Ear Deformities in Hemifacial Microsomia With Three-Dimensional Analysis.

机构信息

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai.

Department of Plastic Surgery, Hainan Women and Children's Medical Center, Hainan, China.

出版信息

J Craniofac Surg. 2022 Jun 1;33(4):1154-1158. doi: 10.1097/SCS.0000000000008342. Epub 2021 Nov 5.

Abstract

This study aimed to explore correlations between mandible and ear deformities and quantitative volumetric relations between condylar structures and external ear in hemifacial microsomia. The authors reconstructed three-dimensional craniofacial models from 212 patients with unilateral hemifacial microsomia (the unaffected side as the controls). Patients were evaluated by Pruzansky-Kaban and Marx classification, and divided into 3 age groups (0-6, 7-12, and >12 years of age). The mandible condylar structures, including condyle and the condylar skeletal unit, were selected (except the classification of the mandibular or ear deformities (M3)). Along with the external ear (except the classification of the mandibular or ear deformities (E4)), their volumes were measured and analyzed. Spearman correlation coefficient analysis was applied. There was a positive correlation between the mandible and ear deformities (r = 0.301, P   <  0.001). Either between the condyle and external ear ( P  = 0.071-0.493) or between the condylar unit and external ear ( P  = 0.080 - 0.488), there were no volumetric relations on the affected side, whereas on the unaffected side were (r = 0.492-0.929 for condyle, r = 0.443-0.929 for the condylar unit, P  < 0.05). In most cases, the condylar structures of the classification of the mandibular or ear deformities (M2b) were significantly smaller than the classification of the mandibular or ear deformities (M2a). Results suggested deformities of mandibular condylar structures and ear did not correlate, although deformities of mandible and ear did. The condylar deformity might develop independently from microtia and be more severe within relatively more abnormal temporomandibular joints.

摘要

本研究旨在探讨半侧颜面短小症患者下颌骨和耳部畸形之间的相关性,以及髁突结构与外耳的定量体积关系。作者从 212 例单侧半侧颜面短小症患者(健侧作为对照组)中重建了三维头面部模型。患者根据普兹赞斯基-卡班(Pruzansky-Kaban)和马克思(Marx)分类法进行评估,并分为 3 个年龄组(0-6 岁、7-12 岁和>12 岁)。选择下颌骨髁突结构,包括髁突和髁突骨骼单位(除下颌骨或耳部畸形分类(M3)外),并与外耳(除下颌骨或耳部畸形分类(E4)外)一起测量和分析其体积。采用 Spearman 相关系数分析。下颌骨和耳部畸形之间存在正相关(r = 0.301,P   <  0.001)。在患病侧,髁突与外耳之间(P  = 0.071-0.493)或髁突单位与外耳之间(P  = 0.080 - 0.488)均无体积关系,而在健侧则存在(髁突 r = 0.492-0.929,髁突单位 r = 0.443-0.929,P  < 0.05)。在大多数情况下,下颌骨或耳部畸形分类(M2b)的髁突结构明显小于下颌骨或耳部畸形分类(M2a)。结果表明,下颌骨髁突结构和耳部畸形之间没有相关性,尽管下颌骨和耳部畸形之间存在相关性。髁突畸形可能与小耳畸形无关,并且在相对更异常的颞下颌关节中更为严重。

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