下颌骨及颧弓测量相关分析在美容医学中的应用

目的原位测量成人下颌角间距及颧弓深度、长度,并进行相关分析,以期在活体上通过测量下颌角间距来推算下颌骨和颧弓深度、长度各项指标,为临床美容矫治术及复合体的制作提供相关资料。方法经甲醛溶液固定成人男、女性尸体各50具,用游标卡尺直接测量下颌骨、颧弓各项指标。结果男性下颌体厚度(12.60±1.26)mm,下颌体高度(33.60±3.35)mm,下颌体长度(77.60±7.80)mm,下颌支宽(34.80±3.50)mm,下颌支高度(67.20±6.70)mm,颧弓深度(9.54±1.19)mm,颧弓长度(40.60±4.97)mm,下颌角厚度(12.20±0.67)mm(P=0.001)。性女下颌体厚度(10.70±0.98)mm,下颌体高度(29.40±2.64)mm,下颌体长度(74.00±7.07)mm,下颌支宽(31.10±3.04)mm,下颌支高(64.00±5.53)mm,颧弓深度(8.67±1.09)mm,颧弓长度(36.50±4.59)mm,下颌角厚度(13.80±1.28)mm等(P=0.001)。结论采用下颌角间宽推算颧弓深度、长度及下颌骨各项指标,对进行美容、复合体制作具有一定的参考意义。     

经颧弓下微创治疗单纯颧弓骨折的临床效果分析

目的:回顾性分析比较经颧弓下微创复位和经口内入路复位治疗单纯颧弓骨折的临床效果.方法:选取2014年1月-2019年12月深圳市人民医院收治的80例单纯颧弓骨折患者为研究对象,采用对照分析,分为微创组和对照组,每组40例.微创组采用经颧弓下微创复位,对照组采用经口内入路复位,术后当天复查CBCT(Cone beam C...     

颧弓缩小在面部“苹果弧”轮廓美学再造及年轻化中的应用

美丽有双重概念,一是年轻;二是轮廓和外形美丽.千百年来,多少学者为此做了大量的实践和探索.现笔者仅就面部轮廓的美学再造作一探讨.面部轮廓的美化是美丽的第一要素,如何标识和塑造面部轮廓美,有多种理论见诸于文献[1-10]。     

颧骨颧弓梭形截骨内推钛钉锚定术治疗颧骨颧弓肥大的疗效观察

目的探讨颧骨颧弓梭形截骨内推钛钉锚定术治疗颧骨颧弓肥大的临床效果。方法 2011年7月-2015年1月,采用颧骨颧弓梭形截骨内推钛钉锚定术,对58例高颧弓患者在盲视下行颧骨颧弓缩小整形。其中男3例,女55例;年龄18~33岁,平均23岁。均为先天性双侧颧骨颧弓肥大。术前摄头面部正位、侧位、仰位、45°斜位照片,并行面部三维CT重建,其中单纯性颧骨肥大30例,颧骨肥大伴颧弓突出28例;颧骨颧弓对称51例,不对称7例。结果术后患者切口均Ⅰ期愈合,无感染、血肿发生。4例出现并发症,其中2例上唇麻木,1例张口受限,1例鼻唇沟加深,均于术后3个月左右自行恢复。58例均获随访,随访时间6~12个月,平均10个月。颧骨间距缩窄10.6~13.9 mm,平均11.2 mm。无面部软组织下垂、颧骨台阶感、面神经损伤,抬眉、闭眼功能障碍及颞下颌关节紊乱综合征等发生。术后骨愈合良好,颧面部感觉无明显异常,所有患者对外观改善均满意。结论颧骨颧弓梭形截骨内推钛钉锚定法可有效缩小颧骨并保持颧骨颧弓的自然曲线,手术方法简便、并发症少、固定稳固,是一种较理想的颧骨颧弓缩小整形术。     

颧骨颧弓的应用解剖研究

目的 测量颧骨、颧弓的突度,观察颧骨、颧弓的形态特征,为人类学、医学提供参考.方法 选取干头骨标本108具,其中男62具,女46具,分别对两侧颧骨、颧弓的突度进行测量;并观察颧骨、颧弓的形态特征.结果 经相关测量显示,颧突点在水平方向上位于颧骨中点,在垂直方向上位于眶下缘中、外1/3交界处下方15～20 mm;颞颧根点（tp）至颧颞上点（ztu）和颧弓深度（zad）分别是：男38.76、12.53 mm.女36.82、8.66 mm.男性颧弓向前、外突出,面宽大于女性.观察颧骨颊面、颧弓上缘、颧骨额突均各见特征.不同国家、不同民族、不同地区的人群存在差异.结论 颧骨、颧弓相对突度及形态特征,对颧骨、颧弓整形手术均有参考意义.     

两种入路颧弓整形的治疗体会

我院自2003年3月～2004年3月共收治颧弓肥大要求整形的病人29例,其中口内入路颧弓整形10例,冠状入路颧弓整形19例.均获得满意的效果,特报道如下。     

颧骨颧弓突出症的改良手术方法

目的：探讨治疗高颧弓的较佳手术方法，方法：颞部入路，在颞深筋膜浅层和深层的浅层间显露颧弓，挫修突出的骨嵴。结果：术后3个月随访，外观满意，效果良好，结论：本法较传统方法创伤更小、更简捷、安全。     

钢丝结扎固定颧骨颧弓整形术稳定性研究

目的：观察钢丝结扎固定颧骨颧弓整形术的稳定性。方法：随机选取颧骨颧弓肥大者59例,于术前、术后10天、术后3个月分别做三维CT检查并进行三维cT重建,用图像分析软件进行测量颧弓宽度。结果：颧骨颧弓整形术后,颧弓宽度明显缩小,且颧弓宽度术后10天和术后3个月无明显变化。讨论：在颧骨颧弓整形术中,运用钢丝行截骨段两端固定,颧弓缩小效果显著且具有良好术后稳定性。     

耳屏前小切口内镜辅助颧弓骨折的复位内固定

目的探讨经耳屏前小切口内镜辅助下颧弓骨折复位内固定的相关技术及临床价值。方法单侧颧弓骨折7例,单侧颧骨、颧弓骨折10例,均采用经耳屏前小切口内镜辅助下颧弓复位内固定治疗。结果所有病例术后双侧颧部对称,无张口、咀嚼功能障碍及明显并发症发生。结论经耳前隐匿小切口内镜辅助下颧弓骨折复位内固定可作为部分颧弓骨折病例治疗的选择术式。     

Infracture Technique for the zygomatic body and arch reduction

In the Orient, prominent malar regions are considered unaesthetic and the majority of women with a prominent malar want to reduce the zygoma. Various operative procedures such as shaving or chiseling the zygomatic body or the zygomatic arch have been used for reducing malar eminence, but the zygomatic arch cannot be reduced sufficiently by these methods. By combining intraoral shaving of the zygomatic body and a new effect arch infracture technique through a temporopreauricular incision, we have obtained very satisfactory results in 19 cases and notable minimal complications over the last three years.     

超声辅助颧弓骨折牵引复位的临床应用

目的：探讨超声辅助下牵引复位导板外固定治疗单纯闭合性颧弓骨折的可行性、准确性及临床应用价值。方法：对40例颧弓骨折在超声监测下钢丝牵引复位,同时根据骨折的方向调整牵引方向使骨折线对齐,导板固定2周后拆除。结果：全部病例复位成功,39例骨折端完全对位整齐,其中1例骨折端垂直向移位对位稍差,但术后功能及外形正常。结论：超声辅助下颧弓骨折复位具有复位疗效好、非手术复位,无X线辐射,费用低、美观,值得临床推广应用。     

Facial-zygomatic triangle: a relationship between the extracranial portion of facial nerve and the zygomatic arch

Summary Background. This study was conducted to clarify the relationships between the extracranial portion of the facial nerve (EFN) and the zygomatic arch (ZA). Method. Four cadaveric heads (8 parotid regions), examined under 3–40× magnification, were dissected from lateral to medial to expose the EFN. Findings. In a vertical plane just anterior to the tragus, the distance from the superior edge of the ZA to the facial nerve (FN) is, on average, 26.88 mm. The FN then courses superiorly and anteriorly, crossing the ZA 18.65 mm anterior to the tragus on average. Thus, three points can be used to depict a triangle: A, at the level of the anterior border of the tragus, just above the superior edge of the ZA; B, 26 mm below A; and C, 18 mm anterior to A. This so called facial-zygomatic triangle represents the area where surgical dissection can be performed with no risk of damaging the FN. Thus, the closer one stays to the tragus, the lesser the risk of damaging the FN below the ZA. If the incision is carried out on a vertical plane closer to the tragus, the skin can be safely cut up to 2 cm below the ZA. Conclusion. The facial-zygomatic triangle is a very useful superficial landmark to avoid FN damage when working below the ZA. Correspondence: Mariano Socolovsky, M.D., La Pampa 1175 Apt. 5A, Buenos Aires 1428, Argentine.     

Hook elevation in reducing the isolated zygomatic arch fractures: is it really a simple and an effective method?

The efficacy of the bone hook elevation method to reduce isolated zygomatic arch fractures was evaluated. Thirty-seven patients with isolated and simple zygomatic arch fractures in whom bone hook elevation was performed between 1992 and 2000 were evaluated. In all the cases, adequate reduction was achieved without any serious complications. The complications encountered were 13.5% imperfect reduction, which could only be diagnosed radiologically, and 16.2% of transient frontal branch paralysis due to anesthesia. The bone hook elevation method is an easy and very inexpensive procedure for the immediate treatment of isolated simple zygomatic arch fractures.     

布巾钳复位治疗单纯颧弓M型骨折的临床观察

目的：探讨布巾钳复位单纯颧弓M型骨折的临床疗效。方法：对15例患者应用布巾钳复位后,利用钢丝和铝板进行外固定,术后影像学随访。结果：15例患者均治愈,无张口受限,面部无瘢痕及神经损伤等症状。结论：该方法创伤小,并能有效恢复颧弓外形及开口功能,获得良好临床疗效。     

微创治疗颧弓颧骨骨折与常规方法的比较

目的:探讨应用微创复位以及常规开放复位的方法对颧弓颧骨骨折病患进行治疗,研究微创治疗颧弓颧骨骨折治疗效果。方法:选取2007年01月～2011年12月到本院进行颧弓颧骨骨折治疗的80例病患为主要的研究对象,均为治疗组,采用回顾性分析方法,将同期80例应用传统治疗方法的患者分为对照组,在治疗组采取微创复位治疗方法对颧弓颧骨骨折病患进行治疗,在对照组采取常规开放复位的方法对颧弓颧骨骨折病患进行治疗,研究治疗前后张口受限情况、骨折对位情况、术后不良反应情况、骨折解剖位愈合情况、面部对称情况、治疗有效率、感觉神经恢复情况、病患满意度情况、治疗费用以及恢复时间等指标。结果:两组研究治疗前后张口受限情况、骨折对位情况以及治疗费用,无显著性差异;两组术后不良反应情况、骨折解剖位愈合情况、面部对称情况、治疗有效率、感觉神经恢复情况、病患满意度情况以及恢复时间等指标,存在显著性差异,有统计学意义。结论:应用微创治疗颧弓颧骨骨折与常规方法的比较,创伤更小,术后不易复发,恢复情况较好,总体效果更加显著,极具安全性,有较高的推广价值。     

Facial reanimation by transposition of the masseter muscle combined with tensor fascia lata,using the zygomatic arch as a pulley

We have created a new way of reanimating the face, involving transposition of the masseter muscle combined with tensor fascia lata, and using the zygomatic arch as a trochlea to reconstruct the inferior facial paralysis. We used it on five patients who had facial palsy after excision of malignant parotid tumours. The wide skin defect that exposed the masseter muscle after total parotidectomy was reconstructed with a free flap. This method differs from those of other methods of transposing the masseter muscle in that force is applied at an upper lateral angle. Our method provided dynamic raising of the upper lip, the corner of the mouth, and the nasolabial fold in four patients. We consider it to be useful, particularly for prompt surgical reconstruction of facial palsy after total parotidectomy with a wide defect in the skin of the cheek.     

8周龄中国实验用小型猪颧弓及顶骨三维测量

目的：获取8周龄中国实验用小型猪颧弓及顶骨三维测量数据,探索幼龄猪颅骨外板修复颧弓缺损的可行性。方法：对15头8周龄中国实验用小型猪进行头颅X线照相及头颅三维CT扫描,用Mimics10.01软件对头颅三维数据进行处理,对重建三维图像进行测量,获得30例颧弓的长度、高度、厚度数据及30例顶骨厚度数据,并将顶骨厚度与颧弓厚度进行比较。结果：8周龄中国试验用小型猪颧弓长度、高度及厚度分别为（28.18±0.94）mm、（12.80±1.56）mm及（3.00±0.51）mm,顶骨厚度为（3.68±0.86）mm。顶骨厚度明显大于颧弓厚度（P=0.004）。结论：8周龄中国实验用小型猪顶骨具有一定的厚度,具有制成颅骨外板的潜力,能够用来进行颧弓重建。