口内入路应用直角钻打孔法截骨及摆动锯截骨矫治下颌角肥大比较探究.docVIP

口内入路应用直角钻打孔法截骨及摆动锯截骨矫治下颌角肥大比较探究[摘要]目的：探索一种简单有效而且风险小的下颌角肥大矫治术。方法：对76例下颌角肥大患者随机分为两组，均采用口内入路。A组37例，全部应用传统的摆动锯进行下颌角截骨术；B组39例，全部应用直角钻打孔法截骨，即在下颌角的预设截骨线上打一排全层穿通的小孔，然后用骨凿凿下要切除的下颌骨。结果：B组患者术中及术后出血明显少于A组，B组术中未有1例损伤知名血管，而A组有3例分别损伤了面动脉和下颌后静脉，术后B组较A组患者肿胀轻，恢复快。随访6个月～1年，两组患者下颌角间距明显变小，外形满意，两组患者满意率没有明显差别。结论：直角钻打孔法截骨和摆动锯截骨矫治下颌角肥大都能达到满意效果，但前者比后者更安全、并发症更少、风险更小。 [关键词]下颌畸形；打孔法；下颌修复术 [中图分类号]R782.2[文献标识码]A[文章编号]1008-6455（2008）10-1472-03 Correction of prominent mandbular angles with right angle bur or oscillating saw by intraoral approach WEN Hui-cai1,LIU Da-lie1,WU Guo-hui2,CHEN Bing1,SHAN Lei1,WANG jing-peng1,HUANG Wen-bo1 （1. Department of Plastic and Cosmetic Surgery, Zhujiang Hospital, Southern Medical University，Guangzhou 510282, Guangdong, China; 2.Department of Plastic Oral Maxillofacial Surgery, Jiangxi Provincial People’s Hospital, Nanchang 330006, Jiangxi, China） Abstract:ObjectiveTo study a simple and effect way of correctingprominent mandibular angle by usingintraoral approach.Methods76 patients with various degrees of prominent mandibular angle were divided into two groups randomly. 37 cases were treated with oscillating saw in A group;39 cases were treated with right angle bur in B group .All cases were performed through intraoral approach.ResultsCompared with A group, patients in B group had less bleeding and complication during operation and postoperative. The overwith of the lower face was effectively corrected in all cases. The cosmetic results determined by both patients and surgeons were followed up 6 to 12 months postoperative.ConclusionOsteotomywith right angle bur or oscillating saw by intraoral approach can achieve a satisfactory result, but the former is simpler and less complication than the latter. Key words: prominent mandbular angles; drilling; osteotomy 下颌角肥大(Prominent mandibular angle)表现为颜面的方形或向外突出的外观，甚至使面部轮廓出现上小下大的形态。从“黄金分割律”原则及美学观点出发，东方民族以“瓜子脸”或“鹅蛋脸”形为美，所以现在要求做下颌角截角来改变脸形的患者越来越多。目前下颌角截骨术主要以口内入路为主，而且传统的口内入路截骨术是用摆动锯或来复锯进行截骨，由于口内入路空间小，用锯