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颜面先天性畸形患者下颌神经管的形态和定量研究。

Morphological and quantitative study of the inferior alveolar nerve canal in hemifacial microsomia.

机构信息

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, People's Republic of China.

出版信息

Sci Rep. 2024 Feb 27;14(1):4753. doi: 10.1038/s41598-024-54318-z.

Abstract

This study aimed to probe into the anatomic course of inferior alveolar nerve canal (IANC) in hemifacial microsomia (HFM) on a large scale, morphological observations and further quantitative study were performed. Patients were classified by Pruzansky-Kaban classification. The anatomic course of IANC was analyzed morphologically with three-dimensional (3D) imaging software among 248 patients. Seven distances between fixed landmarks on both sides were measured for 236 patients. The differences between affected and unaffected sides were compared. Significant differences were found in the entrance (P < 0.001), route (P < 0.001), and exit (P < 0.05) of IANC in type IIb and III HFM. The higher the degree of mandibular deformity was, the higher the incidence of IANC variation was (P < 0.05). The distances in the horizontal aspect of IANC including from mandibular foramen to mental foramen (P < 0.05) and from mental foramen to gonion (P < 0.05) were significantly shorter on the affected side. Abnormalities of the anatomical course of IANC exist in patients with Pruzansky-Kaban type IIb and type III HFM. The reduction of IANC on the affected side in the horizontal distance is more obvious. Three-dimensional imaging assessment is recommended before surgery.

摘要

本研究旨在大规模探讨颜面一侧发育不全(HFM)患者下牙槽神经管(IANC)的解剖路径,进行形态学观察和进一步的定量研究。患者根据 Pruzansky-Kaban 分类进行分类。对 248 例患者进行三维(3D)成像软件分析 IANC 的解剖路径。对 236 例患者的两侧固定标志之间的 7 个距离进行了测量。比较了患侧和健侧的差异。在 IIb 型和 III 型 HFM 中,IANC 的入口(P<0.001)、路径(P<0.001)和出口(P<0.05)差异有统计学意义。下颌畸形程度越高,IANC 变异发生率越高(P<0.05)。IANC 水平方向的距离,包括从下颌孔到颏孔(P<0.05)和从颏孔到下颌角(P<0.05),患侧明显缩短。Pruzansky-Kaban Ⅱb 型和Ⅲ型 HFM 患者 IANC 的解剖路径存在异常。患侧 IANC 在水平距离上的减少更为明显。建议在手术前进行三维成像评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3627/10899633/71ce1d592d34/41598_2024_54318_Fig1_HTML.jpg

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本文引用的文献

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Modern Mandibular Distraction Applications in Hemifacial Microsomia.现代下颌骨牵引术在半面短小症中的应用。
Clin Plast Surg. 2021 Jul;48(3):375-389. doi: 10.1016/j.cps.2021.02.001. Epub 2021 May 8.
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Branching Patterns of Mental Nerve in Newborns.
J Craniofac Surg. 2020 Oct;31(7):2025-2028. doi: 10.1097/SCS.0000000000006611.
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Course of the mandibular canal in hemifacial microsomia: a retrospective computed tomography study.半侧颜面短小畸形下颌管走行的回顾性 CT 研究。
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Nov;128(5):558-563. doi: 10.1016/j.oooo.2019.03.017. Epub 2019 Apr 1.
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Costochondral grafting in craniofacial microsomia.颅面短小畸形中的肋软骨移植术。
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