基于三维测量的下颌角截骨术后面下部软组织变化的临床研究。
Changes in Facial Soft Tissues After Mandibular Angle Ostectomy Based on 3-Dimensional Measurement: A Clinical Study.
机构信息
Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Staff Surgeon, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
出版信息
J Oral Maxillofac Surg. 2022 Sep;80(9):1493-1504. doi: 10.1016/j.joms.2022.05.010. Epub 2022 Jun 1.
PURPOSE
A limited number of clinical studies have focused on the changing trends of facial soft tissue after mandibular angle ostectomy. We conducted this study to investigate the changes in facial muscles and facial soft tissue appearance before and after mandibular angle ostectomy.
MATERIAL AND METHODS
A single-center retrospective cohort study was conducted on female patients admitted to our hospital for mandibular angle ostectomy between 2019 and 2020. The primary predictor variable was time (preoperative vs 6 months postoperative). The primary outcome variables were surface area and total volume of the manually delineated region of interest (ROI) for the masseter and temporalis muscles. We utilized computed tomography data to reconstruct 3-dimensional models to delineate muscle ROI and then measure them computationally. Secondary outcome variables were indicators of mandible appearance in soft tissue including bilateral mandibular angle distance, mandibular ramus height, and mandibular angle value. Age, preoperative body mass index, and ostectomy volume were chosen as covariates for correlation analysis with outcome variables. Paired t tests and Pearson correlation analysis were conducted, and P values < .05 were considered statistically significant.
RESULTS
A total of 29 female patients (mean age, 26 years; range, 18 to 37 years) who underwent mandibular angle ostectomy in our hospital were included. The surface area and total volume of the masseter muscle ROI were reduced by 2,541.2 ± 1,925.0 mm (12.8%; P < .05) and 16,242.4 ± 12,646.8 mm (18.4%; P < .05), respectively, 6 months after surgery. In contrast, the surface area and total volume of the temporalis muscle ROI increased by 6,081.6 ± 6,169.4 mm (12.0%; P < .05) and 19,273.3 ± 21,666.2 mm (10.7%; P < .05), respectively. The ostectomy volume showed a correlation coefficient of 0.59 with postoperative masseter ROI change (P < .05).
CONCLUSION
We observed statistically significant levels of atrophy of the masseter muscle ROI and expansion of the temporalis muscle ROI 6 months after mandibular angle ostectomy, which may account for appearance changes after surgery. Besides, ostectomy volume positively correlates with postoperative masseter ROI changes. In summary, our study provided empirical evidence illustrating soft tissue alterations in patients who have undergone mandibular angle ostectomy.
目的
少数临床研究集中在下颌角截骨术后面部软组织的变化趋势上。我们进行这项研究是为了调查下颌角截骨术前和术后面部肌肉和面部软组织外观的变化。
材料和方法
对 2019 年至 2020 年间在我院行下颌角截骨术的女性患者进行单中心回顾性队列研究。主要预测变量是时间（术前与术后 6 个月）。主要结局变量是咀嚼肌和颞肌手动勾画感兴趣区域（ROI）的表面积和总体积。我们利用 CT 数据重建 3 维模型来勾画肌肉 ROI，然后进行计算测量。次要结局变量是软组织下颌外观的指标，包括双侧下颌角距离、下颌升支高度和下颌角值。年龄、术前体重指数和截骨量被选为与结局变量相关的协变量进行相关性分析。进行配对 t 检验和 Pearson 相关分析，P 值<.05 认为具有统计学意义。
结果
共纳入我院行下颌角截骨术的 29 例女性患者（平均年龄 26 岁，范围 18-37 岁）。术后 6 个月，咀嚼肌 ROI 的表面积和总体积分别减少了 2541.2±1925.0mm（12.8%；P<.05）和 16242.4±12646.8mm（18.4%；P<.05）。相比之下，颞肌 ROI 的表面积和总体积分别增加了 6081.6±6169.4mm（12.0%；P<.05）和 19273.3±21666.2mm（10.7%；P<.05）。截骨量与术后咀嚼肌 ROI 变化的相关系数为 0.59（P<.05）。
结论
我们观察到下颌角截骨术后 6 个月咀嚼肌 ROI 明显萎缩，颞肌 ROI 明显扩张，这可能是术后外观变化的原因。此外，截骨量与术后咀嚼肌 ROI 变化呈正相关。总之，我们的研究提供了经验证据，表明下颌角截骨术后患者的软组织发生了改变。
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