弧形截骨术和外板劈除术对下颌角形态变化的比较

目的探讨和比较下颌角弧形截骨成形术后和下颌角外板劈除术后对下颌角肥大患者下颌角的形态变化差异。方法对下颌角肥大行弧形截骨成形术的30例和行下颌角外板劈除术后的20例的头颅正、侧位片进行测量比较。结果下颌角弧形截骨成形术使下颌角间距变小,下颌角角度变钝,下颌升支长度变短,下颌角点向前上移位,下颌角区的下颌骨最大宽度变小,下颌骨升支及体部变窄;下颌角外板劈除法可以使下颌角间距变小,而下颌升支长度,下颌角区的下颌骨最大宽度,下颌骨升支及体部的宽度均无明显变化。结论下颌角弧形截骨成形术对面下部正面观和侧面观均有较大改善,下颌角外板劈除术主要对面下部正面观有较大改善,在进行下颌角肥大成形术时,应注意手术适应证的选择。

Changes of mandibular angle after curved osteotomy and angle-splitting osteotomy: a comparative study

Objective To study and compare changes of mandibular angle shape after curved osteotomy and angle-splitting osteotomy. Methods 30 patients suffering from prominent mandibular angle, who underwent curved osteotomy, were selected. 20 patients suffering from prominent mandibular angle, who underwent angle-splitting osteotomy, were also selected. X-ray of skull was measured and the results were compared. Results After curve osteotomy, interval of mandibular angle decreased; angle of mandibular angle increased; length and width of mandibular ramus and width of mandiblar body decreased. After angle-splitting osteotomy, interval of mandibular angle decreased, while change of length of ramus and width of mandibular ramus and mandiblar body were not obvious. Conclusions After curved osteotomy, changes of anterior view and lateral view of basifacial part are obvious. And after angle-splitting osteotomy, changes of anterior view of basifacial part are also obvious. Therefore, different procedure should be selected in contouring of the prominent mandibular angle.