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1.
口内切口内窥镜直视下下颌角缩小整形术   总被引:3,自引:1,他引:2  
目的:口内切口下颌角整形由于切口和解剖结构的限制,手术视野和操作空间较为局限,我们希望借助内窥镜技术,来探寻一种直视下操作的下颌角整形手术方法。方法:采用全口内切口,内窥镜下设计画线,磨削减薄下颌骨外板、弧形切除肥大的下颌角、斜面修整下颌缘,在直视下使下颌骨三维立体缩小。结果:2005年以来,我们应用全口内切口入路内窥镜下下颌角缩小整形术256例,效果满意。结论:①全口内切口入路,体表不会遗留任何手术痕迹;②内窥镜下设计画线,准确对称;手术操作均在直视下进行,安全可靠;③手术采用弧形去除肥大的下颌角,使下颌角弧度自然完美;完整削薄下颌骨外板,使面部正面完整缩小;精细修整下颌缘,使整个下颌部位轮廓更加流畅柔美,从而面中下部位立体有效地缩窄。  相似文献   

2.
目的了解广东成年女性安氏Ⅰ类开唇露齿患者拔除4个第1双尖牙矫正后软组织侧貌变化情况,评价该类患者矫正后软组织变化的意义。方法回顾性研究15例广东成年女性安氏Ⅰ类开唇露齿患者,用头颅侧位分析法分析拔牙矫正前后软组织X线片,再将同一测量值于矫正前后做配对t检验,了解有无显著性差异,分析判断矫正后唇组织变化的意义。结果在角度方面:鼻唇角、上下唇角、Z角增加;线距方面:上下唇长和上下唇厚加大,而上下唇审美平面距和上下唇突距皆缩小,且变化有统计学意义;面凸角、面角、上下唇基角和颏厚等变化无统计学意义。结论该类患者拔除4个第1双尖牙的矫正可以使患者面部严重不协调关系有明显改善;但唇厚较治疗前加大,唇间距仅部分缩小,上前牙仍有部分外露,患者仍然有开唇露齿的面像,其进一步好转依赖于患者唇肌功能的改善。  相似文献   

3.
孙兆霞  崔春红 《中国美容医学》2014,23(20):1717-1720
目的:测量汉族青年女性唇部软组织正常值,探讨唇部软组织正常值间相关性以及与面型的关系。方法:选择2012~2013级在校女学生(共70名,年龄18~19岁;均为汉族),采用面部软组织直接测量口唇各部高度均值、口列宽度均值、正面三庭均值、面宽均值、形态面高和容貌面高均值、内眦距离均值。结果:面部软组织直接测量获得口唇各部高度均值(唇高:3.45±0.608、上唇高:1.95±0.317、上白唇高:1.29±0.326、上红唇高:0.67±0.201、下唇高:1.55±0.349、下白唇高:0.79±0.336、下红唇高:0.77±0.199、上下红唇高:1.48±0.297)cm、口列宽度均值(4.37±0.341)cm、正面三庭均值(上庭:5.92±0.770、中庭:5.75±0.427、下庭6.07±0.607)cm、面宽均值(14.40±1.174)cm、形态面高(11.85±1.144)cm和容貌面高(18.59±1.234)cm均值、内眦距离均值(3.32±0.339)cm。结论:1建立青年女性口唇形态测量相关指标的正常参考值;2口裂宽与内眦距离(P=0.005)、上唇高(P=0.000)、唇高(P=0.007)有正相关(P0.01),唇形态改变的趋势是越厚越宽,越窄越薄;3上唇高(P=0.043)、下唇高(P=0.004)和唇高(P=0.011)与上庭有正相关;4唇高与唇各部高度(除下红唇高无相关)均呈正相关,且与上唇高和下唇高相关性显著(P=0.000);上唇高与唇各部高度(除下白唇高无相关)均呈正相关,且与上红唇高、上下红唇高、上白唇高及唇高相关性显著(P=0.000),而与下红唇高有相关性(P=0.002),且上红唇高对上唇高影响较上白唇高影响大;下唇高与下白唇高(P=0.000)、唇高(P=0.000)相关性显著,颏唇沟位置对下唇高度影响大;上红唇高与上下红唇高相关性显著(P=0.000);(P0.01);5唇各部高度和宽度与容貌面高、形态面高和面宽无相关性(P0.05)。6以上唇形态正常参考值及相关性对整形外科提供形态学基础。  相似文献   

4.
This article reports the simultaneous reconstruction of maxillary and mandibular defects caused by a close-range gunshot blast to the face with one fibular osteocutaneous flap combined with an anteroateral fasciocutaneous flap. A fibular osteocutaneous flap was used for both mandibular and maxillary defects, using multiple osteotomies and discarding a central bony segment and an oral floor defect. An anterolateral thigh flap was used to cover a three-dimensional defect of both the intraoral mucosal region, as well as external skin and soft tissue defects, including some on the upper and lower lips. The results demonstrated that the method was a good choice in the reconstruction of large composite facial defects, both aesthetically and functionally.  相似文献   

5.
Background  The authors have developed a new digital photogrammetric method of facial analysis known as balanced angular and proportional analysis (BAPA). Using BAPA, the authors analyzed the faces of attractive Korean entertainers. Methods  The BAPA approach involves 28 landmarks and 14 measurements (10 proportional and 4 angular measures). Standardized mean angular values of famous entertainers are referred to as recommended aesthetic mean angles (RAMA) and the mean proportional values as the recommended aesthetic mean proportions (RAMP). In this study, 30 frontal views of famous Korean entertainers (15 men and 15 women) were collected from Internet Web pages, and the data analyzed using V-ceph. A t test (with the significance level set at a p value of 0.05) was performed to analyze male versus female comparisons. Results  Significant between-group differences (p < 0.05) were found for P-lower face, P-eye height, P-lip, P-interangle, and the mandibular contour in the frontal views. Famous Korean female entertainers differ from famous male entertainers. The women have a shorter lower face, larger eyes, smaller lips, and a more slender and oval shape of the mandibular soft tissue contour. Conclusions  The authors insist that facial analysis should take into consideration racial, ethnic, and gender differences. The BAPA approach is a new practical and simple method for photogrammetric facial analysis. Using the authors’ method, more advanced and automated computer systems for analyzing human faces may be developed.  相似文献   

6.
BackgroundAsian women usually view the oval face, with a beautiful curve and clear outline, as elegant. The fat and bloated mid-lower face, with an undefined outline, takes away from what they perceive to be a beautiful appearance. Not only a bone but also soft tissue determine the shape of the mid-lower face. In this article, we introduce a modified surgical method of soft tissue for mid-lower facial recontouring, which can improve the fat and undefined outline of the mid-lower face caused by benign masseter muscle hypertrophy and reduce subcutaneous fat accumulation at the same time. The operative technique is simple and effective with few complications.MethodsThe surgical treatment of 36 patients who met the adaptation criteria was carried out by laser-assisted liposuction combined with masseter muscle dissection. All patients were followed up postoperatively, and the surgical efficacy was evaluated on the basis of: the comparison of facial contours of patients before and after surgery, the change of masseter muscle thickness detected by B-ultrasound imaging, the satisfaction of patients with postoperative facial contour improvement, and the incidence of complications.ResultsBetween March 1, 2018, and August 31, 2019, 36 patients with indications underwent this procedure. The follow-up lasted 6 to 12 months postoperatively and demonstrated that all patients were satisfied with the postoperative results, of which 33 cases (91.7%) were very satisfied, and 3 cases (8.3%) were satisfied with the treatment and had obvious improvement of the appearance of their mid-lower face. Preoperatively, the average mandibular bigonial breadth was 138.6±8.3 mm, and the average thickness of the masseter muscle was 13.9±0.8 mm; the postoperative breadth was 123.3±7.7 mm, and the thickness was 10.1±0.2 mm. The average reduction of the lower face width and masseter thickness were 15.2±2.1 mm and 3.8±0.1 mm, respectively. No complications occurred among the 36 patients.ConclusionThe described method makes a great improvement in reshaping the outline of the mid-lower face, improves the fat and unclear outline of the mid-lower face caused by masseter muscle hypertrophy, and reduces subcutaneous fat accumulation. The procedure is easy to perform and is minimally traumatic, allowing for a quick recovery with few complications. These advantages along with the patients’ overall satisfaction with the results make it worthy of clinical application.  相似文献   

7.
Facial aging changes due to increased skin laxity as well as soft tissue atrophy and decent lead to blunting and distortion of previously well-defined zones of the face and neck. A critical component of re-establishing a youthful appearance during facelift and neck lift surgery is restoring a well-defined mandibular contour. Key principles of jawline refinement include the addition of volume to deficient areas and removal of volume in areas of unwanted fullness to re-establish facial harmony in the lower face and neck. In this article, we describe a novel classification of jawline zones and discuss our stepwise surgical approach to aid in the systematic evaluation and surgical treatment of the jawline.  相似文献   

8.
Background  Reduction in lip volume is a stigmata of the aging face. There are many lip augmentation techniques but very few studies analyzing how these techniques change the three-dimensional structure of the lips. Furthermore, there is no consensus about whether the lip position should be standardized to either the lips closed or parted. The aim of this study was first to obtain a three-dimensional quantitative analysis of the lips in adults and to look for sexual dimorphism and, second, to compare whether more consistent measurements of the oral region can be obtained with the mouth open compared with it closed. Methods  Seventy young Caucasian volunteers underwent lip dimension analysis using 3D stereophotogrammetry with lips parted and closed. Parameters measured for consistency of results were linear distances (e.g., mouth width, total lip height, upper lip height), surface distances (e.g., upper vermilion), areas (e.g., vermilion upper and lower lip, total vermilion), and volumes (upper and lower lip volume, total lip volume). Analysis also compared lip dimensions between male and female subjects. Results  Consistent and reproducible results were seen with the lips closed compared with lips apart. All lip parameters (distances, areas, and volumes) were larger in men than in women. The following measurements had significant differences between males and females: mouth width, upper lip height median, upper white lip height median, upper white lip height lateral, lower vermilion surface distance, and area of vermilion (p < 0.05). Conclusion  We present a novel technique for aesthetic assessment of the lips that is objective and achieves consistency with the lips in the closed position. Males have greater lip dimensions compared with females.  相似文献   

9.
The purpose of this study was to compare facial growth in patients with unilateral complete cleft lip and palate (UCLP) in whom the palate was repaired with the von Langenbeck procedure at 8 months (L-8), or the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference series. Sixty-one adult patients, 34 in the L-8 group and 27 in the W-18 group, were investigated clinically and with lateral skull radiography and also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effects of the surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal jaw relations, vertical jaw relations, and inclination of incisors. The UCLP group was characterised by a short (n-sp) and retrusive maxilla (s-n-ss) and a retrusive mandible for women (s-n-sm), larger maxillary inclination (NSL/NL), more retroclined lower incisors (IL(I)/ML), shorter upper facial heights (n-sp) and normal total face height (n-gn) than the reference group. In the UCLP group there were significant differences between men and women in mandibular prognathism (s-n-sm), maxillary/mandibular relations (ss-n-sm), maxillary inclination (NSL/NL), total anterior facial height (n-gn), and upper anterior facial height (n-sp). Lateral crossbite was found in 20% of the UCLP group. The prevalence was similar in the L-8 and W-18 groups. Almost 80% of the patients in the UCLP group considered that their dental condition was good. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.  相似文献   

10.
The purpose of this study was to compare facial growth in patients with unilateral complete cleft lip and palate (UCLP) in whom the palate was repaired with the von Langenbeck procedure at 8 months (L-8), or the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference series. Sixty-one adult patients, 34 in the L-8 group and 27 in the W-18 group, were investigated clinically and with lateral skull radiography and also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effects of the surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal jaw relations, vertical jaw relations, and inclination of incisors. The UCLP group was characterised by a short (n-sp) and retrusive maxilla (s-n-ss) and a retrusive mandible for women (s-n-sm), larger maxillary inclination (NSL/NL), more retroclined lower incisors (ILI/ML), shorter upper facial heights (n-sp) and normal total face height (n-gn) than the reference group. In the UCLP group there were significant differences between men and women in mandibular prognathism (s-n-sm), maxillary/mandibular relations (ss-n-sm), maxillary inclination (NSL/NL), total anterior facial height (n-gn), and upper anterior facial height (n-sp). Lateral crossbite was found in 20% of the UCLP group. The prevalence was similar in the L-8 and W-18 groups. Almost 80% of the patients in the UCLP group considered that their dental condition was good. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.  相似文献   

11.
Preoperative assessment of breast volume could contribute significantly to the planning of breast reconstructive surgery. However, breast volume measurements are not carried out on a routine basis, because there is still no commonly accepted standard method for such measurements. In the current study, we assessed whether routine computed tomography (CT) of the chest using a three-dimensional device could provide accurate estimation of breast volumes in patients with breast cancer. Ten consecutive patients and 11 breasts with breast cancer that underwent mastectomy with immediate breast reconstruction were enrolled in this study. In each case, a three-dimensional image was constructed according to the CT data using a volume-rendering technique. Computed breast volumes were compared with known breast volumes obtained from surgical specimens. The mean breast volume of surgical specimens was 324.1 ± 173.5 mL. The mean breast volume value was established to be 351.6 ± 174.3 mL with three-dimensional CT in a novel method. There was a strong linear association between breast volumes of surgical specimens and breast volumes measured by the three-dimensional CT method when using a Pearson correlation (r = 0.985, P < 0.001). Our results suggest that the calculation of breast volume using three-dimensional CT is accurate enough to have a significant clinical benefit in planning reconstructive breast surgery. This method can help the surgeon predict the esthetic effect of various breast surgeries and guide the choice of the most appropriate implant preoperatively.  相似文献   

12.
颅颌面双侧不对称畸形的综合治疗   总被引:3,自引:0,他引:3  
目的 探讨先天性及发育性一侧颜面发育不良或萎缩所致颅颌面双侧不对称畸形的综合手术治疗。方法 针对患者的畸形情况,设计相应的手术方案以重建患侧的外形及功能。骨骼畸形不明显而主要为软组织萎缩凹陷者,可采用软组织移植的手段予以充填修复;对同时伴有颅面骨骼发育不良的患者,首先重建面部的骨骼支架,在此基础上,再进一步完成软组织的修复。结果 1998年9月至2004年8月,共治疗各种原因导致的双侧颜面不对称畸形患者42例,其中单侧颅面短小畸形22例,进行性半侧颜面萎缩16例,肿瘤切除后放疗导致的邻近区域软组织及骨骼的发育不良4例。男18例,女24例。年龄16~38岁,平均24岁。2例肿瘤术后放疗患者,因局部软组织条件差,发生钛板及植入骨外露,1例单侧颅面短小畸形患者采用自体下颌骨外板及肋骨行下颌升支重建后发生感染,致手术失败,其余患者双侧不对称畸形均获得明显改善。结论 单侧颜面发育不良或萎缩所致颅颌面双侧不对称畸形,是临床上常见且治疗难度较大的一组畸形,畸形轻重程度不等,涉及软组织和骨组织的治疗。需根据患者的具体情况,合理设计手术方案,综合运用整形及颅颌面外科技术分期手术重建,方可达到最大程度改善外形、恢复功能的目的。  相似文献   

13.
正畸与正颌外科联合治疗下颌发育不足   总被引:2,自引:2,他引:0  
陈嵩  陈扬熙 《中国美容医学》2004,13(1):56-57,C005
目的:通过X线头影测量的方法对接受正畸—正颌外科联合治疗的中、重度下颌发育不足畸形患者术前、术后的软组织侧貌进行分析,从美学的角度对治疗的效果进行评价。方法:搜集接受正畸—正颌外科联合治疗的中、重度下颌发育不足畸形成人患者共18例作为研究样本,对患者术前、术后的软组织侧貌进行头影测量分析。结果:18例患者治疗结束后软组织侧貌改善明显,侧面角、软组织面角和Z角,以及下面高显著增大;上、下唇凸度显著减小。结论:对于中、重度骨性下颌发育不足畸形,正畸—正颌外科联合治疗能够获得理想的侧貌改善。  相似文献   

14.
基于点云数据建立下颌骨数字模型   总被引:4,自引:0,他引:4  
目的通过CT数据建立临床下颌骨数字模型,探讨其在颅颌面外科面部轮廓整形的应用前景。方法选择32例要求面下部轮廓整形的临床病例,均行全头颅螺旋CT连续薄层容积扫描,数据传至工作站后行三维重建,建立全头颅数字模型,通过数据切割原理建立颌骨术前及术后截骨的数字模型,并转换成stl文件格式。结果32例下颌角肥大的临床病例均建立下颌角截骨手术设计的数字模型。结论基于点云数据建立下颌角肥大病例的数字模拟手术模型,对未来个性化面部轮廓整形的治疗具有重要的临床实用价值。  相似文献   

15.
目的:利用头颅定位X线片实现颅面部软组织的三维重建及测量。方法:同期分次摄取侧位、45°位和正位头颅定位X线片。利用侧位和45°位X线片上相匹配的外加金属标志点,获得颅面部软组织的三维信息,进行颅面部软组织形态的三维重建。在所建面部三维模型基础之上选8个解剖标志点,进行10项测量,并与人群的正常值进行比较研究。结果:利用侧位和45°位的两张X线片,对颅面部软组织实现三维重建。建立了颅面部软组织的三维测量系统,测量结果同正常值相比较,除面宽和下颌宽有较大的差异外,测量值都具有很好的同一性,面部比例指数除去面宽和下颌角宽的影响大多数都有较好的一致性。结论:本系统基于头颅定位X线片实现颅面部软组织的三维重建和测量,为面部畸形的诊断,正颌手术的定量化手术设计,术后疗效评价提供新的技术方法。  相似文献   

16.
Facial aesthetic surgery procedures have evolved to the highest level possible, the three-dimensional restructuring of facial form. Repositioning of the deep soft tissue planes from the neck to the zygoma as well as subperiosteal, upper, and midface elevation have become commonplace. Alloplastic implant contouring is not only a useful adjunct, but it should be a fundamental tool used with the variety of new facial aesthetic techniques. It is now possible for the aesthetic surgeon to variously restore, rejuvenate, or enhance facial forms of either hereditary or aging origins. Infinite variations in facial contour are now possible. By using alloplastic techniques based on concepts of zonal anatomy and aesthetic deficiency typing, the bony and soft tissue contours of the face can be created or modified with a minimum of complications. The use of alloplastic implants on the "fourth skeletal plane" represents an optimum, significant, three-dimensional manipulation of both the soft tissues of the face and the skeletal anatomic elements of mass and volume.  相似文献   

17.
目的:评价上颌前牵引早期矫正上颌发育不足产生的骨性Ⅲ类错(牙合)后的侧貌美学改变。方法:选取19例骨性Ⅲ类前牙反(牙合)的生长发育期患者,男9例,女10例,年龄8-13岁,平均10.5岁,所有病例均处于生长发育高峰期或高峰前期,口内戴用上颌全基托式活动矫治器,口外采用面具式牵引架进行上颌前牵引矫治,矫正前牙反(牙合),至前牙反(牙合)解除,建立正常覆(牙合)覆盖矫治完成。测量比较矫治前后软组织美学指标的改变。结果:前牵引矫治后,软组织面角减小2.4°,H角变小3.65°,上唇沟点前移3.45mm,上唇缘点前移2.85mm,Pgs-VL距离显著减小1.70mm,下面高增加2.95mm,矫治后上唇前移,额部后下移。下唇位置改变不大。结论:上颌前牵引可使Ⅲ类凹面型得到明显改善,后缩的上唇治疗后均显著前移,颏部后下移动,使侧貌更协调美观。  相似文献   

18.
目的探讨女性上颌前突患者正颌术后鼻唇区软组织的三维变化特点。方法北京大学口腔医院收治88例女性上颌前突畸形患者,年龄18~42岁,平均28.2岁。所有患者上颌均行Le FortⅠ型分块截骨术,通过拔除2颗上颌第一前磨牙创造间隙后退上颌骨。上颌前突并下颌后缩患者,下颌行双侧升支矢状劈开截骨术移动下颌体部,双颌前突患者下颌行根尖下截骨术。分别在术前1~3 d及术后至少6个月拍摄3dMD照片,获取面部三维图像,使用Geomagic Studio 2013软件测量手术前、后软组织三维标志点坐标以及线距、角度的变化,并进行三维偏差分析。测量结果进行配对t检验,P<0.05为差异具有统计学意义。结果上颌前突患者鼻下点在矢状向的距离术前为(-10.90±18.60)mm,术后为(-10.05±18.62)mm(t=-7.66,P<0.001),后退了(0.85±1.00)mm;上唇缘点术前为(-15.18±18.67)mm,术后为(-11.92±18.90)mm(t=-21.97,P<0.001),后退了(3.26±1.40)mm。鼻翼宽度术前为(37.32±2.32)mm,术后为(38.08±2.32)mm(t=-4.85,P<0.001),增加了(0.76±1.47)mm;口角宽度术前为(49.17±3.54)mm,术后为(47.68±3.74)mm(t=5.77,P<0.001),减小了(1.49±2.42)mm;人中长度术前为(15.20±2.32)mm,术后为(15.78±2.17)mm(t=-4.70,P<0.001),增加了(0.58±1.16)mm;鼻唇角术前为101.98°±9.34°,术后为109.05°±8.59°(t=-12.36,P<0.001),增大了6.99°±5.35°。三维偏差分析显示,术后鼻旁区软组织前移了(1.54±0.73)mm。结论正颌术后女性患者鼻底及上唇均显著后退,鼻旁区出现前移,并伴随鼻翼变宽、口角宽度减小、人中变长、唇红变薄、鼻唇角增大等改变。  相似文献   

19.
The results of surgical treatment for facial paralysis are still difficult to compare as there is no universal scoring method. The purpose of this communication is to review the results of reconstruction of the extratemporal facial nerve with nerve grafts using our own evaluation system. Fifty-nine patients were operated on during the period 1981–1991. They had lacerations or other trauma to the face which resulted in loss of continuity of the facial nerve or branches. Three groups were considered: (a) 12 patients had injuries involving the trunk and extending up to the main branches of the facial nerve; (b) 32 patients had parotid laceration or contusion on the parotid area with resulting nerve defects extending from a main branch up to distal branches; and (c) 15 patients had injuries on the distal branches: frontal, zygomatic, or mandibular. The sural nerve was used as the graft in all instances. The grafting procedure was performed from three weeks to six months after the trauma. The method of evaluation compares the normal with the paralyzed side. A score is given of 0 (no motion), 1 (weak motion), or 2 (strong motion), for each of six voluntary contractions: forehead, closure of eyelids and lips, traction, elevation, and depression of the lips. The assessment of involuntary mimic actions was done while observing blinking, speaking, smiling, and laughing. Mass movements were scored negatively. The numbers were recorded and the ratio between the paralyzed and normal side gave an estimate of the lack of symmetry. Differences between the preoperative and postoperative scores showed that improvement had been achieved by surgery. Nerve grafting provided a significant improvement of function in patients with traumatic injuries to the extratemporal facial nerve. © 1994 Wiley-Liss, Inc.  相似文献   

20.
目的:对西安地区汉族骨性II类面型青年进行颅面部软组织的三维测量,将该年龄组的骨性II类面型颅面部各器官之间的三维测量值进行研究,为临床诊断和制定治疗计划提供参考依据。方法:采用Farkas的颅面部软组织表面测量方法,对西安地区面部形态为凸面型的60名汉族青年进行54项测量,将测量结果与司新芹用同法测量的正常面型青年面部软组织三维测量值进行对比。结果:通过抽样调查发现,西安地区西安籍骨性II类面型青年相对正常面型青年在三维方向的特点是:上颌相对下颌前突,颏下点相对后缩(中面1/3弧>t-gn-t下面1/3弧,P<0.01);面下1/3较窄(下颌宽:骨性II类面型<正常面型,P<0.01)。结论:西安地区西安籍骨性II类面型青年相对正常面型青年面部软组织在三维方向上存在较大的差异。  相似文献   

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