Mommaerts M Y, Abeloos J V, De Clercq C A, Neyt L F
Department of Surgery, General Hospital St. John, Brugge, Belgium.
J Craniomaxillofac Surg. 1995 Feb;23(1):12-9. doi: 10.1016/s1010-5182(05)80248-3.
The classical approach to lateral midface hypoplasia is reconstruction with onlays. Dislocation and asymmetry, early and late infection, and extrusion are possible complications with alloplastic implant materials. Unpredictable resorption, irregular contours and asymmetry are problems that can arise with autogenous, homogenous and hetergenous onlay grafts. We describe a technique by which the zygomatic body is luxated laterally and ventrally after a combined oblique-horizontal and vertical osteotomy. The resultant greenstick fracture at the temporo-zygomatic suture together with minimal lateral degloving causes the malar body to return to its former position. An interpositional porous hydroxyapatite block acts as a space maintainer until the osteotomy sites are ossified. The restoration of contour is performed by the zygomatic body itself, not by the implants. The indications are discussed and the results of three year follow-up are illustrated.
治疗侧面中面部发育不全的经典方法是采用嵌体进行重建。使用异体植入材料可能会出现移位和不对称、早期和晚期感染以及植入物挤出等并发症。自体、同种和异种嵌体移植可能会出现不可预测的吸收、轮廓不规则和不对称等问题。我们描述了一种技术，即在进行斜水平和垂直联合截骨术后，将颧骨体向外侧和腹侧脱位。颞颧缝处形成的青枝骨折以及最小程度的外侧皮肤脱套导致颧骨体恢复到原来的位置。置入的多孔羟基磷灰石块起到空间维持器的作用，直到截骨部位骨化。轮廓的恢复是由颧骨体自身完成的，而不是通过植入物。本文讨论了该技术的适应证，并展示了三年随访结果。
