【摘要】：中文摘要： 背景：面斜裂是累及面部旁中線結(jié)構(gòu)的一種先天性顱面畸形。面斜裂的治療包括骨和軟組織的重建。應用計算機輔助設(shè)計的序列手術(shù)流程,包括下頜骨外板移植結(jié)合內(nèi)眥韌帶復位固定,在治療面斜裂方面取得很好的臨床效果。 方法：本研究包括我科從2004年1月到2013年12月收治的12位面斜裂患者,在我科接受了下頜骨外板自體骨移植以及內(nèi)眥韌帶復位固定�；颊叩钠骄挲g為18歲(范圍,13到25歲),應用數(shù)字化3D外科技術(shù)輔助進行手術(shù)設(shè)計,應用自體下頜骨外板貼附植骨在骨缺損和骨凹陷部位,同期或再期行患側(cè)內(nèi)眥韌帶的復位固定術(shù),重建面部的對稱性。對患者的臨床記錄、照片和放射檢查資料進行了回顧性研究。 結(jié)果：所有的患者都獲得了顯著的治療效果和較好的滿意度�；颊咦晕一纬潭鹊脑u分明顯降低�；颊咦晕以u價畸形嚴重程度的10分簡易量表得分在術(shù)后有顯著降低(p0.001),術(shù)后6到12個月后也沒有明顯的差異(p=0.069)。內(nèi)眥韌帶的位置得到了改善(p＜0.001),沒有明顯的復發(fā)(p=0.096)。下頜骨供區(qū)的恢復程度平均為(48.44±16.89)%(范圍,11.03%到71.33%)。移植骨塊被吸收體積為原移植骨塊的28.67±14.39%(范圍,12.58%to69.17%)。比較各移植部位的骨塊吸收程度均沒有統(tǒng)計學差異。在6例患者中出現(xiàn)非常輕微容易修復的并發(fā)癥。 結(jié)論：這種序列手術(shù)方法對于面斜裂的治療是有效的。術(shù)后取得了較好的患者滿意度,也得到了面部對稱性的改善。術(shù)后遺留的皮膚疤痕相對其他自體骨移植較少,而且術(shù)后骨塊吸收程度也可以接受,下頜骨供區(qū)也有明顯的恢復。計算機輔助分析和手術(shù)模擬設(shè)計面斜裂的治療方案可以有效的描述顱面部骨骼畸形的特點,為手術(shù)重建提供有用的指導。
[Abstract]:Abstract: background: oblique facial fissure is a congenital craniofacial malformation involving the midline of parafafacial structure. The treatment of oblique facial fissure includes bone and soft tissue reconstruction. The sequence procedure of computer aided design, including mandibular external plate transplantation and medial canthus ligament reduction and fixation, has achieved good clinical results in the treatment of oblique facial fissure. Methods: this study included 12 patients with oblique facial fissure treated in our department from January 2004 to December 2013. We accepted autogenous bone transplantation of external plate of mandible and reduction and fixation of medial canthus ligament in our department. The average age of the patients was 18 years (ranging from 13 to 25 years). The surgical design was assisted by digital 3D surgical techniques. Autogenous mandibular plates were used to attach grafts to bone defects and depressions. The reconstruction of facial symmetry was performed at the same time or in another stage by the reduction and fixation of the medial canthus ligament on the affected side. The clinical records, photographs and radiographic data of the patients were retrospectively studied. Results: all patients received significant therapeutic effects and satisfactory results. The score of the degree of self-deformity was significantly decreased. The scores of 10 mini-scales for self-evaluation of deformity were significantly decreased after operation (p0.001), and there was no significant difference 6 to 12 months after operation (p0. 069). The location of the medial canthus ligament was improved (p < 0.001), and there was no obvious recurrence (p0. 096). The average recovery of mandibular donor area was (48.44 鹵16.89)% (range from 11.03% to 71.33%). The absorbed volume of the graft was 28.67 鹵14.39% of the original graft (range 12.58 to 69.17%). There was no significant difference in the degree of bone graft resorption among the grafts. In 6 patients, complications were very mild and easy to repair. Conclusion: this sequence procedure is effective for the treatment of oblique facial fissure. Good patient satisfaction and facial symmetry were achieved after operation. Compared with other autogenous bone grafts, the residual skin scars were less, and the degree of bone graft resorption was acceptable, and the mandibular donor region recovered obviously. Computer-aided analysis and surgical simulation can describe the characteristics of craniofacial bone deformities and provide useful guidance for surgical reconstruction.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：TP391.7;R782.2

【參考文獻】

相關(guān)期刊論文 前3條

1 梁娟,王艷萍,繆蕾,吳艷喬,朱軍,周光萱;中國圍產(chǎn)兒面斜裂病例的調(diào)查分析[J];華西口腔醫(yī)學雜志;2000年03期

2 歸來,王吉昌,張智勇,劉偉,牛峰,金驥,夏德林,俞冰,羅金超;下頜骨外板修復面斜裂鼻眶骨畸形[J];中華整形外科雜志;2005年02期

3 劉國軍,高善嶺,周銳華,孫家明;面斜裂整形修復中淚道重建術(shù)的探討[J];中國修復重建外科雜志;1997年01期

，

本文編號：2258947