内镜辅助隆颏术临床观察.doc

内镜辅助隆颏术临床观察[摘要]目的：探讨内镜在隆颏术中的临床应用价值。方法：口内下唇系带旁小直切口，不切断颏肌。在内镜辅助下，行颏前区骨膜下剥离，松解颏神经并予保护，在直视下植入多孔聚乙烯颏植入体，钛钉固定。本组共完成32例，均为先天性小颏畸形就医者。其中女25例，男7例，年龄18～45岁。结果：内镜完全可以清楚显示前颏和下颌体及颏神经，视野清晰，创伤小，无颏神经永久性损伤和下唇功能障碍。颏轮廓改善满意。结论：内镜辅助隆颏术有助于获得良好的手术效果。 [关键词]小颏畸形；植入体；内镜 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2007）10-1395-02 Endoscopic assisted augmentation of alloplastic chin CHEN Xiao-ping,WANG wei,SHEN Jian,LIN Jie,YANG Zhen-yu (Department of Plastic and Aesthetic Surgery, Hangzhou Plastic Surgery Hospital,Hangzhou310014, Zhejiang, China) Abstract:ObjectiveTheaimofthisstudywastoevaluatetheclinicalapplication ofendoscopic techniquein augmentationofalloplastic chin.MethodsAtotalof32 patients(age18～45years, women 25, men 7) withmicrogeniawere performedoperationbyendoscope-assisted aminimallyintraoralstraightincisionwithsubperiostealexposure of the mandibular mentumarea.Themental muscle not be cut onthe approach,noterelaxtion ofthe mental nerves, the use of two-piece porous polyethylene implants for augmentationandscrew fixation of the implant to the mandible. Screw fixation improves the predictability and precision of reconstruction by preventing implant displacement, by obliterating gaps between the implant and the facial skeleton, and by facilitating final implant contouring.ResultsThis approach allowed anatomically correct, stable chin contours to be created.Soft-tissue distortion resulting from implant migration and scar contracture have been avoided. There have been no mental nerve injuries. The use of anendoscope offers a clear view of the region to be augmented and easy placedimplants. ConclusionIt is showed that the endoscopicassisted augmentation of alloplastic chin offers more satisfactory clinical results with a clear view of operation and less soft-tissue distortion,preventing mental nerve injuries, ruduced surgical trauma. Key words: microgenia; implant; endoscope 内镜技术使外科手术中的医源性创伤大为降低，已成为美容外科引用的新技术之一。我科采用内镜辅助技术行隆颏术，有效防止了隆颏术中的颏神经损伤和术后的下唇功能障碍，获得了良好效果。 1材料和方