Craniomaxillofacial Surgery Department 1 of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Aesthetic Plast Surg. 2024 Jun;48(11):2025-2033. doi: 10.1007/s00266-024-03955-w. Epub 2024 Mar 27.
To assess submental-cervical soft tissue changes after en bloc mandibular U-shaped osteotomy and examine alterations in the anterior belly of digastric muscle (ABDM).
A retrospective study analyzed 20 patients who underwent en bloc mandibular U-shaped osteotomy from 2018 to 2023. Preoperative (Tp) and long-term follow-up (Tf) CT data were collected for analysis, measuring mandibular volume, soft tissue thickness at menton (Mes) and cervicale (C), and ABDM parameters (length, cross-sectional area (CSA), volume, distance from centroid point to the mandibular margin). Correlation analyses were performed to investigate the connection between soft tissue thickness changes, ABDM changes, and mandibular osteotomy volume.
Long-term follow-up revealed a significant increase in soft tissue thickness at the Mes and C points after U-shaped mandibular osteotomy, especially at the C point. The adaptive length of ABDM decreased, CSA increased, and volume decreased, but the ABDM centroid point shifted downward relative to the mandibular margin, indicating drooping protrusion. The increment of soft tissue thickness was moderately positively correlated with the amount of osteotomy, and the decrement of ABDM length and volume were slightly positively correlated with the amount of osteotomy.
The degree of soft tissue relaxation after U-shaped osteotomy is related to the extent of osteotomy. Notably, the protrusion of ABDM relative to the mandibular margin affects submental-cervical contour aesthetics. Prior to U-shaped osteotomy, it is crucial to assess the soft tissue condition of the patient's lower face, and the individualized design of the osteotomy volume should be carried out cautiously and safely.
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评估整块下颌骨 U 形截骨术后颏下-颈部软组织的变化，并检查二腹肌前腹（ABDM）的变化。
回顾性研究分析了 2018 年至 2023 年期间接受整块下颌骨 U 形截骨术的 20 例患者。收集术前（Tp）和长期随访（Tf）的 CT 数据进行分析，测量下颌骨体积、颏下（Mes）和颈部（C）的软组织厚度以及 ABDM 参数（长度、横截面积（CSA）、体积、质心点到下颌缘的距离）。进行相关分析以研究软组织厚度变化、ABDM 变化与下颌骨截骨体积之间的关系。
长期随访发现 U 形下颌骨截骨术后颏下和颈部软组织厚度明显增加，尤其是颈部。ABDM 的适应性长度缩短，CSA 增加，体积减小，但 ABDM 质心点相对于下颌缘向下移动，表明下垂突出。软组织厚度的增加与截骨量呈中度正相关，ABDM 长度和体积的减少与截骨量呈轻度正相关。
U 形截骨术后软组织松弛的程度与截骨量有关。值得注意的是，ABDM 相对于下颌缘的突出会影响颏下-颈部轮廓的美学。在进行 U 形截骨术之前，评估患者下面部的软组织状况非常重要，应谨慎、安全地设计个体化的截骨量。
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