MacIntosh R B
J Maxillofac Surg. 1981 Aug;9(3):151-65. doi: 10.1016/s0301-0503(81)80036-7.
This report surveys the experience in 236 patients operated on by the author, of whom 155 provided records complete enough to provide information on all the elements of postoperative evaluation. Patients were evaluated at a minimum of 2 years after surgery. The patients had an average age of 23 years, and were predominantly female in a ratio of more than 4:1. No intraoperative or postoperative physiologically threatening problems as elsewhere described in the literature, such as profound blood loss, airway obstruction, or gross loss of bone substance, were encountered. An immediate postoperative paraesthesia incidence of almost 85% was observed, which diminished to 9% 1 year postoperatively. The prolonged paraesthesia were most common in patients over 40 years of age; similarly, healing was prolonged in patients over 40, prompting the author's recommendation that 8 weeks intermaxillary fixation rather than 6 be employed in these patients. The overall relapse rate was approximately 30%; this was clinically significant in approximately 12% of patients, and required reoperation in 4 patients. Relapse was most marked in apertognathic patients, demonstrating, in the author's opinion, that the sagittal ramus osteotomy should not be used, in general, in open-bite cases. The particulars of the technique and the author's views on regression are presented.
本报告调查了作者为236例患者实施手术的经验，其中155例患者提供了足够完整的记录，可用于提供术后评估所有要素的信息。患者在术后至少2年接受评估。患者平均年龄为23岁，女性占主导地位，男女比例超过4:1。未遇到文献中其他地方描述的术中或术后生理上有威胁的问题，如大量失血、气道阻塞或骨质大量丢失。观察到术后即刻感觉异常发生率近85%，术后1年降至9%。感觉异常持续时间较长在40岁以上患者中最为常见；同样，40岁以上患者愈合时间延长，促使作者建议这些患者采用8周而非6周的颌间固定。总体复发率约为30%；这在约12%的患者中具有临床意义，4例患者需要再次手术。开颌患者复发最为明显，作者认为，一般而言，矢状升支截骨术不应应用于开颌病例。文中介绍了该技术的细节以及作者对复发的看法。
