Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.
Cleft Palate Craniofac J. 2024 Mar;61(3):483-491. doi: 10.1177/10556656221131855. Epub 2022 Oct 7.
The aim of this study was to evaluate the outcomes of orthognathic surgery (OGS) in patients with craniofacial microsomia (CFM) who had previously undergone mandibular distraction osteogenesis (MDO).
A retrospective cohort study was performed including all patients with CFM who were treated with OGS at a single institution between 1996 and 2019. The clinical records, operative reports, and cone beam computed tomography (CBCT) scans were reviewed. CBCT data before OGS (T1), immediately after OGS (T2), and at long-term follow-up (T3) were analyzed using Dolphin three-dimensional software to measure the occlusal cant and chin point deviation.
The study included 12 patients with CFM who underwent OGS (6 underwent OGS without MDO and 6 underwent OGS after MDO). There was a statistically significant improvement in occlusal cant and chin point deviation in both groups postoperatively. Occlusal cant relapsed by a mean of 0.6° (standard deviation [SD] 1.1°) in the patients who had OGS alone compared with 0.7° (SD 1.2°) in the patients who had OGS after MDO ( = .745) between T2 and T3. There was no statistically significant difference in chin point relapse between patients who had OGS alone compared with those who had OGS after MDO (0.1 mm [SD 2.5mm] vs 0.7mm [SD 2.2mm]; = .808).
Within the limitations of this study, these findings suggest that OGS after MDO in patients with CFM can produce stable results.
本研究旨在评估曾行下颌骨牵引成骨术（MDO）的颅面骨发育不全（CFM）患者行正颌手术（OGS）的治疗效果。
本研究为回顾性队列研究，纳入了 1996 年至 2019 年期间在单一机构接受 OGS 治疗的所有 CFM 患者。回顾了临床记录、手术报告和锥形束计算机断层扫描（CBCT）扫描。使用 Dolphin 三维软件分析 OGS 前（T1）、OGS 后即刻（T2）和长期随访（T3）的 CBCT 数据，以测量咬合倾斜和颏点偏斜。
研究纳入了 12 例 CFM 患者，其中 6 例患者行单纯 OGS，6 例患者行 MDO 后 OGS。两组患者术后咬合倾斜和颏点偏斜均有显著改善。单纯 OGS 组的咬合倾斜复发平均为 0.6°（标准差 [SD] 1.1°），而 MDO 后 OGS 组为 0.7°（SD 1.2°）（ = .745），在 T2 和 T3 之间。单纯 OGS 组与 MDO 后 OGS 组颏点复发无统计学差异（0.1mm[SD 2.5mm]与 0.7mm[SD 2.2mm]； = .808）。
在本研究的限制范围内，这些发现表明 CFM 患者 MDO 后行 OGS 可获得稳定的效果。
