颌骨牵引成骨在矫正半侧颜面发育不全中的应用

目的：探讨颌骨牵引成骨技术矫正半侧颜面发育不全的临床应用，牵引器设计等有关问题。方法使德国Martin公司及国产两种不同设计之升支牵引器，完成了半侧颜面发育不全患者矫治手术11例，平均年龄14．1岁，最大23岁，最小4．5岁。最长牵引成骨30mm,最短15mm，牵引矫治过程中配合正畸治疗，部分患者同时行LeFOrtⅠ型截骨术及水平截骨颏成形术等。结果11例患者及家属均对治疗结果表示满意。无1例感染或成骨不良等并发症发生，1例牵引3d时因牵引器故障重新更换了牵引器，继续完成了牵引。部分患者牵引过程中有疼痛，口唇麻木等一时性反应，通过改变牵引速度与频率自行缓解。结论牵引成骨技术是目前矫正此类畸形的最佳选择，较传统方法不仅简化了治疗程序，降低了创伤及手术风险，而且取得了更好的治疗效果。

Application of distraction osteogenesis in correction of hemifacial microsomia

OBJECTIVE: To study the effect of distraction osteogenesis of mandibular ramus in correcting hemifacial microsomia. METHODS: From December 1997 to March 2000 two kinds of mandibular distractors made in Germany and China were used in 11 cases with hemifacial microsomia aged 4.5 approximately 23 years (on average 14.1 years). Orthodontic treatment was given during the distraction. LeFort I osteotomy and genioplasty were performed in 5 cases and 4 cases respectively. RESULTS: The treated mandibular rami were lengthened 15 approximately 30 mm. No infection and dysosteogenesis was found. In only one case, the distractor failed to function at the third day of treatment and was replaced. The distractor was removed after 3 months while new bone was formed in all cases. All of the patients and their family members expressed their satisfaction with the results of treatment. CONCLUSION: Mandibular distraction osteogenesis is the most effective procedure for correcting hemifacial microsomia.