颧骨颧弓缩小联合下颌角截骨术前及术后早期颞颌关节和咬肌的三维螺旋CT形态学测量

目的:探讨颧骨颧弓缩小联合下颌角截骨术前、术后颞颌关节和咬肌的变化。方法:随机选取颧骨颧弓及下颌角肥大者80例,于术前、术后10天分别做三维CT检查,并对颜面部进行三维测量,采用自身对照进行配对资料t检验。结果:颧骨颧弓及下颌角截骨整形术后0°指标及60°指标术前术后差异无统计学意义(P>0.05),120°指标及180°指标术前术后差异有统计学意义(P<0.05);咬肌宽度及厚度术前术后差异有统计学意义(P<0.05)。结论:颧骨颧弓及下颌角截骨整形术后短期内颞颌关节上间隙及关节后间隙发生了改变,差异有统计学意义但差值较小,颞颌关节的改变仍在其代偿范围内;由于术中部分骨质的去除及咬肌被剥离附着位置发生改变再加上手术操作对咬肌的损伤,咬肌的形态随之改变,短期内咬肌宽厚度较术前增大。

Masseter muscle and temporomandibular joint early changes Pre-and post reduction plasty of mala and zygoma and mandibular angel ostectomy :Evaluation by 3DCT

Objective To investigate the change of Masseter muscle and temporomandibular joint after reduction plasty of mala and zygoma and mandibular angel ostectomy. Methods 3DCT facial soft and hard tissue measurement was performed before and. 10 days after the surgery in 80 cases of prominent malar-complex and mandibular angle.Pre-and post-operative self-control and PairedSamples T Test were used. Results Statistical difference between the pre-and post-operative data were found in 120°and 180° measures,also in the width and length of masseter,but were not found in 0°and 60°measures. Conclusion In the short term after reduction plasty of mala and zygoma and mandibular angel ostectomy,temporomandibular joint upper-and aft-space are changed,there are statistical difference,but not significant.The changs still in compensation range.Because of osteotomy, masseter muscle attached position is changed and inevitably injuried during the operation,masseter configuration is changed as well,the width and length of masseter are increased in a short time.