牵张成骨术治疗复杂颌面骨骼缺损和畸形

目的:探讨用牵张成骨技术治疗常规方法处理困难的颌面骨骼缺损和畸形。方法:18例无法采用常规方法治疗的多类颅颌面畸形患者,分别使用外置式和内置式牵张器进行骨牵张术矫治。术前均作外科模型和必要的头影测量。术后延迟期为7天,牵张节律为lmm/天,2～4次/天,牵张结束后常规固定6～8周。结果:术后伤口正常愈合,牵张过程顺利,均达到预期牵张目的,无严重并发症发生。患者的咬合关系和面形均得到恢复。腭裂治疗后继发畸形患者最大牵张距离为20mm,最小距离为15mm;下颌骨重建患者最大牵张距离为30mm。下颌骨垂直牵张患者固定期近牵张区出现病理性骨折,但未出现错位,经内固定处理,牵张完成后,未出现畸形愈合情况或骨不连接。结论:骨牵引延长技术可以很好地适用于多种颅颌面骨畸形或骨缺损患者的治疗,尤其适用于软组织量不足、不易覆盖移植骨的患者,而且不需要另取自体骨移植。

Correction of Complex Cranio-maxillofacial Deformity by Distraction Osteogenesis

Objective To investigate the application of distraction osteogenesis technique in correction of complex cranio-maxillofacial deformity. Methods 18 patients with different cranio-maxillofacial deformity were included in this study. Distraction osteogenesis technique was used to correct the deformity and malocclusion. Orthognathic surgery were done when necessary. Results The treatment process were smooth, no severe complication occurred. All the patients were satisfied for the good results. Conclusion Distraction osteogenesis is a good method for correction of complex cranio-maxillofacial deformity. Tissue transplantation is unnecessary; operation is not very complex and treatment is low risk. But the treatment period is long.