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通过导向板辅助下颌角截骨术矫正面部不对称。

Correcting facial asymmetry through guided plate assisted mandibular angle osteotomy.

作者信息

Han Wenqing, Yichi Zhang, Kim Byeong Seop, Sun Mengzhe, Chai Gang

机构信息

Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Surg. 2024 Aug 1;11:1391231. doi: 10.3389/fsurg.2024.1391231. eCollection 2024.

Abstract

BACKGROUND

Asian women prefer a smooth and narrowed mandibular appearance. The purpose of the retrospective cohort study is to evaluate guide plate-assisted mandibular angle ostectomy (MAO) in improving mandibular symmetry for Asian female patients with mandibular angle hypertrophy (MAH) with normal occlusal relationship.

METHODS

We retrospectively examined 11 patients with asymmetry MAH with normal occlusal relationship who received MAO at Shanghai Ninth People's Hospital between September, 2020, and January, 2022. Preoperative plans were designed based on CT data and executed using metal guide plate during the operation. Preoperative and one-week postoperative CT scans were used to assess measurements including Height_Go, Divergence_Go, ∠ZyZy-GoGo, and osteotomy volume, to evaluate symmetry. For precision, compare the postoperative CT with the preoperative design, assessing osteotomy distance, angle, and volume error. Patient satisfacation was evaluated with Likert Scale in 6-month follow-up. Secondary lipofilling procedures were given as appropriate. Statistical analysis was performed using paired t-tests in SPSS.

RESULTS

The mean age of the 11 patients was 28.5 years (range 23-34 years). 2 of these underwent lipofilling procedures. No complications were observed during the following-up. Postoperative results were not statistically different from the design, demonstrating a precision of within 2 mm. Height_Go disparity within 5 mm get corrected notably, reducing asymmetry from 15.09% preoperatively to 2.74% postoperatively. Patients satisfaction was rated at 4.5 out of 5 in 6 month follow-up.

CONCLUSIONS

Guide plate-assisted mandibular angle osteotomies achieve effective and precise surgery. This approach demonstrates a safe option for correction for mandibular asymmetry, achieving patient satisfaction.

摘要

背景

亚洲女性更喜欢下颌外观平滑且变窄。这项回顾性队列研究的目的是评估导板辅助下颌角截骨术(MAO)对具有正常咬合关系的亚洲女性下颌角肥大(MAH)患者下颌对称性的改善情况。

方法

我们回顾性研究了2020年9月至2022年1月期间在上海第九人民医院接受MAO的11例具有正常咬合关系的不对称MAH患者。术前计划基于CT数据设计,并在手术期间使用金属导板执行。术前和术后一周的CT扫描用于评估包括Height_Go、Divergence_Go、∠ZyZy - GoGo和截骨体积等测量值,以评估对称性。为了评估精度,将术后CT与术前设计进行比较,评估截骨距离、角度和体积误差。在6个月的随访中使用李克特量表评估患者满意度。根据需要进行二次脂肪填充手术。使用SPSS中的配对t检验进行统计分析。

结果

11例患者的平均年龄为28.5岁(范围23 - 34岁)。其中2例接受了脂肪填充手术。随访期间未观察到并发症。术后结果与设计无统计学差异,显示精度在2毫米以内。5毫米以内的Height_Go差异得到显著纠正,不对称性从术前的15.09%降至术后的2.74%。在6个月的随访中,患者满意度评分为4.5分(满分5分)。

结论

导板辅助下颌角截骨术实现了有效且精确的手术。这种方法是矫正下颌不对称的安全选择,能让患者满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7be1/11324470/d0ce2cfa3c64/fsurg-11-1391231-g001.jpg

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