Polley J W, Figueroa A A
University of Illinois at Chicago, Division of Plastic Surgery 60612, USA.
J Craniofac Surg. 1997 Sep;8(5):422-30. doi: 10.1097/00001665-199708050-00017.
The reconstruction of severe mandibular deformities in patients with hemifacial microsomia (HFM) is difficult. The multiple requirements include temporomandibular joint construction, mandibular ramus and body reconstructions with autogenous bone grafts, and soft tissue facial augmentation. The sequencing of these reconstructions include staged procedures, generally performed at the time of skeletal maturity. Mandibular distraction osteogenesis has gained popularity as a technique for managing patients with mandibular hypoplasia. However, the use of distraction osteogenesis in HFM patients with severe grade III mandibular deformities has not been previously addressed. The purpose of this report is to present our early findings with the clinical application of mandibular distraction osteogenesis in HFM patients with grade III mandibular deformities. In selected patients, mandibular distraction osteogenesis can be beneficial by improving overall facial symmetry and balance. Mandibular distraction osteogenesis has unique advantages for these patients in that it can be performed early in childhood with minimal morbidity. Through the use of clinical examples, the application, patient selection, and advantages and disadvantages of mandibular distraction osteogenesis in HFM patients with grade III mandibular deformities are discussed.
半侧颜面短小畸形（HFM）患者严重下颌骨畸形的重建手术颇具难度。其涉及多项要求，包括颞下颌关节重建、采用自体骨移植进行下颌升支和体部重建，以及面部软组织填充。这些重建手术的顺序安排包括分期手术，一般在骨骼发育成熟时进行。下颌骨牵张成骨术作为治疗下颌骨发育不全患者的一项技术已逐渐普及。然而，此前尚未有关于在重度Ⅲ级下颌骨畸形的HFM患者中应用牵张成骨术的相关报道。本报告的目的是展示我们在重度Ⅲ级下颌骨畸形的HFM患者中临床应用下颌骨牵张成骨术的早期发现。在选定的患者中，下颌骨牵张成骨术通过改善整体面部对称性和平衡可能具有益处。下颌骨牵张成骨术对这些患者具有独特优势，因为它可在儿童早期进行，且发病率极低。通过临床实例，讨论了下颌骨牵张成骨术在重度Ⅲ级下颌骨畸形的HFM患者中的应用、患者选择以及优缺点。
