Vargervik K, Ousterhout D K, Farias M
Cleft Palate J. 1986 Dec;23 Suppl 1:53-68.
Mandibular malformations in patients with hemifacial microsomia are described and six phases of treatment outlined. Growth of the malformed mandibular ramus in response to functional appliance treatment was studied in 15 subjects with type I mandibular malformations. It was found that length increase of the affected side during the treatment period was not significantly different from the growth of the other side. Changes in length of the affected side of the mandible following surgical repositioning and bonegrafting was assessed in 25 consecutive cases. In 10 of these subjects, the surgical procedure was done during the growth period and in 15 of them after growth had ceased. In the still growing subjects, there was additional length increase of the reconstructed mandibular ramus, but on an average, less than on the side which had normal temporomandibular joint structures. In seven cases, the length increase was similar on the two sides ( +/- 2 mm) or greater on the affected side, and the established symmetry was maintained. In three subjects, there was recurrence of asymmetry, which in two individuals was corrected by a second surgical lengthening of the mandible. There was minimal loss in length of the reconstructed mandibular ramus in the nongrowing subjects and the established mandibular position was maintained.
描述了半侧颜面短小畸形患者的下颌骨畸形情况，并概述了六个治疗阶段。对15例I型下颌骨畸形患者进行了研究，观察了畸形下颌升支在功能性矫治器治疗后的生长情况。发现治疗期间患侧的长度增加与另一侧的生长情况无显著差异。对25例连续病例进行了评估，观察下颌骨患侧在手术复位和植骨后的长度变化。其中10例患者在生长发育期进行了手术，15例在生长停止后进行了手术。在仍在生长的患者中，重建的下颌升支有额外的长度增加，但平均而言，比颞下颌关节结构正常的一侧要少。在7例患者中，两侧的长度增加相似（±2mm）或患侧增加更大，且维持了已建立的对称性。在3例患者中，不对称复发，其中2例通过再次手术延长下颌骨得到纠正。在非生长型患者中，重建的下颌升支长度损失最小，且维持了已建立的下颌位置。
