上下颌同步牵张成骨治疗半侧颜面萎缩畸形

目的探讨上下颌骨同步牵张成骨矫正半侧颜面萎缩畸形的临床效果。方法半侧颜面萎缩患者3例，男2例，女1例，年龄14～19岁。临床及X线检查见一侧上下颌骨明显萎缩伴同侧软组织萎缩，牙合]平面严重偏斜。患者萎缩侧上下颌骨同期行牵张器植入术并同步牵张成骨，于牵张成骨结束后6～8个月行背阔肌瓣软组织充填术。结果萎缩侧上下颌骨平均牵张20mm。颜面软硬组织得到明显改善，面颊部丰满，牙合]平面矫正，咬合关系良好。随访1～4年，患侧新骨和软组织无明显吸收，面部基本对称。结论矫正半侧颜面萎缩时，同侧上下颌骨同步牵张成骨是延长萎缩的上下颌骨，改善牙合]平面并为软组织充填提供支撑的有效治疗方法。

Correction of hemifacial atrophy by maxillomandibular distraction osteogenesis in atrophy side

Objective To investigate the effect of treating hemifacial atrophy and correcting oblique occlusion plane by simultaneous distraction osteogenesis of maxilla and mandibule in atrophy side. Methods Three patients （Male：2 Female：1 ） with hemifacial atrophy were involved. Clinical and X-ray examination showed sever atrophy of bone and soft tissues in one side of face, with seriously oblique occlusion plane. Distractors were embodied into atrophic maxilla and mandible respectively and distraction osteogenesis were performed simultaneously. The latissimus myofacial flaps were used to correct soft tissue 6 ～ 8 months after distraction osteogenesis finished. Results Both maxilla and mandible were lengthened 20 mm averagely in atrophic side and the deformities of both bony and soft tissue were improved evidently and occlusion relationship was established well. Following up ranged from 1 to 4 years, patients demonstrated symmetric faces without regenerated bones and soft tissue absorbed. Satisfactory facial contour and profile were achieved. Conclusions Simultaneous distraction osteogenesis of maxilla and mandible in atrophic side is an effective method to lengthen atrophic jaws, correct the oblique occlusion plane and improve the result of soft tissue fillings.