Klein C, Howaldt H P
Department of Maxillo-facial Surgery, J. W. Goethe University Medical School, Frankfurt am Main, Germany.
J Craniomaxillofac Surg. 1995 Apr;23(2):68-74. doi: 10.1016/s1010-5182(05)80451-2.
Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint (TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth. Furthermore, these procedures often require intermaxillary fixation and sometimes blood transfusions. Lengthening of the mandible by gradual distraction, according to the method of Ilizarov, opens new perspectives for interceptive therapy. This paper reports on this method applied in 9 cases of mandibular hypoplasia. Out of 3 bilateral and 6 unilateral mandibular distractions the average amount of bone lengthening was 21 mm, ranging from 15 to 25 mm. In order to facilitate ossification, the mandibles were maintained in external fixation for an average of 9 weeks subsequent to the period of active lengthening. Thereafter, immediate postoperative orthodontic treatment is necessary to avoid a relapse. No complications were noted during the follow-up period (max 17 months).
单侧或双侧下颌骨发育不全可能与多种综合征相关，或者是在颞下颌关节（TMJ）早期遭受创伤或炎症性疾病后获得性的。早期治疗对于避免随后的面中部生长受损是必要的。这些畸形的标准治疗方法包括应用骨移植，这可能导致不可预测的生长。此外，这些手术通常需要颌间固定，有时还需要输血。根据伊利扎罗夫方法通过渐进性牵引延长下颌骨，为早期治疗开辟了新的前景。本文报道了该方法应用于9例下颌骨发育不全的病例。在3例双侧和6例单侧下颌骨牵引中，平均骨延长量为21毫米，范围为15至25毫米。为了促进骨化，在积极延长期之后下颌骨平均保持外固定9周。此后，需要立即进行术后正畸治疗以避免复发。随访期间（最长17个月）未发现并发症。
