Polley J W, Figueroa A A, Liou E J, Cohen M
Craniofacial Center, University of Illinois, Chicago, USA.
Plast Reconstr Surg. 1997 Feb;99(2):328-39. doi: 10.1097/00006534-199702000-00005.
Reconstruction of the mandible is one of the key elements in the skeletal rehabilitation of patients with hemifacial microsomia. Unfortunately, knowledge about long-term mandibular skeletal growth in these patients is lacking. The purpose of this study was to analyze mandibular skeletal growth longitudinally in unoperated hemifacial microsomia patients from childhood to adolescence. The longitudinal records of 26 patients with unoperated unilateral hemifacial microsomia were utilized. The average age at initial records was 3.1 years, and the average age at final records was 16.7 years. Posteroanterior cephalometric radiographs were utilized to evaluate both horizontal and vertical mandibular asymmetry. Patients also were analyzed according to the grade and side of the mandibular deformity. A paired t-test (p < 0.05) and a two-way ANOVA were used to analyze the data. There were 5 patients with grade I, 14 with grade II, and 7 with grade III. The results indicated that the skeletal mandibular asymmetry in hemifacial microsomia is not progressive in nature and that growth of the affected side in these patients parallels that of the nonaffected side. The grade and the side of the mandibular deformity did not influence these findings. These results should be considered when treatment strategies are developed to reconstruct the asymmetrical mandible in hemifacial microsomia.
下颌骨重建是半侧颜面短小畸形患者骨骼康复的关键要素之一。遗憾的是，目前缺乏关于这些患者下颌骨长期骨骼生长的知识。本研究的目的是纵向分析未经手术治疗的半侧颜面短小畸形患者从儿童期到青春期的下颌骨骨骼生长情况。利用了26例未经手术治疗的单侧半侧颜面短小畸形患者的纵向记录。初次记录时的平均年龄为3.1岁，末次记录时的平均年龄为16.7岁。利用正位头影测量X线片评估下颌骨的水平和垂直不对称情况。还根据下颌骨畸形的程度和侧别对患者进行了分析。采用配对t检验（p < 0.05）和双向方差分析对数据进行分析。其中I级患者5例，II级患者14例，III级患者7例。结果表明，半侧颜面短小畸形患者的下颌骨骨骼不对称在本质上并非进行性的，且这些患者患侧的生长与未患侧平行。下颌骨畸形的程度和侧别并未影响这些结果。在制定治疗策略以重建半侧颜面短小畸形患者的不对称下颌骨时，应考虑这些结果。
