Knipper P, Mitz V, Lemerle J P
Service de Chirurgie Plastique, Hôpital Boucicaut, Paris, France.
Ann Chir Plast Esthet. 1996 Feb;41(1):37-44.
The elegance of the cervical region is due to a certain balance between concave and convex surfaces, and is based on the presence of a well-defined cervicomental angle, generally between 90 degrees to 110 degrees. An excessively wide-open cervicomental angle makes the cervical profile inelegant. Numerous surgical techniques can improve this angle. There is however a certain limit to this correction: an excessively caudal and anterior hyoid bone. In this case the last proposal is a modification of the hyoid bone position in order to replace it in a backward and upper location. To achieve this goal we studied postero-superior suspension of the hyoid bone by plication of the tendon of the digastric muscle in 20 anatomic dissection. Each an dissection was controlled by x-ray of the profile of the cervical region before and after application of this technique. Cephalometric measures were performed and statistically analysed using the "Paired t-test" on Statview II. Analysis of the results after the plication of the tendon of the digastric muscle, demonstrated an average closing of the cervicomental angle of 25.6 degrees with an average ascent of the hyoid bone of 13.27 millimeters and an average posterior transposition of 3.75 millimeters. This experimental cervicoplasty appears to be feasible. A precise surgical technique has been developed with an easy approach to the digastric tendon during standart faced lift procedures. The effect of the compression generated on the pharyngo-oesophageal complex by posterior transposition of the hyoid bone is unknown. This problem is now under investigation.
颈部的优美形态归因于凹面与凸面之间的某种平衡,且基于一个界限分明的颌颈角的存在,该角度通常在90度至110度之间。颌颈角过度张开会使颈部轮廓显得不美观。众多手术技术可改善此角度。然而,这种矫正存在一定限度:舌骨过度靠下且靠前。在这种情况下,最后的方案是改变舌骨位置,将其置于向后上方的位置。为实现这一目标,我们在20例解剖标本中通过折叠二腹肌肌腱对舌骨进行后上悬吊研究。每例解剖在应用该技术前后均通过颈部轮廓X线进行对照。进行了头影测量,并使用Statview II上的“配对t检验”进行统计学分析。对二腹肌肌腱折叠后的结果分析显示,颌颈角平均缩小25.6度,舌骨平均上移13.27毫米,平均向后移位3.75毫米。这种实验性的颈部成形术似乎是可行的。已开发出一种精确的手术技术,在标准的面部提升手术中可轻松触及二腹肌肌腱。舌骨向后移位对咽食管复合体产生的压迫作用尚不清楚。这个问题目前正在研究中。