牵引成骨重建下颌骨髁突缺损

提要：下颌骨髁突缺损及发育不足是临床常见疾病，常造成患者患侧下颌支高度降低、咬合紊乱及面部畸形，严重影响患者身心健康。牵引成骨由于具有无免疫排斥、无供区损伤、精确可控、可改善软组织形态的特点，是一种较为理想的治疗方法。本文旨在结合作者的临床经验及国内外文献，对下颌支牵引成骨髁突重建进行评述，主要就治疗时机、术前设计及模拟、术中术后控制及注意要点等进行讨论。

Orthognathic surgery of denofacial deformaity Distraction osteogenesis for the reconstruction of mandibular condylar defect

Summary：Condylar defects and ramus hypoplasia usually result from trauma， temporomandibular joint ankylosis，congenital and acquired deformities，which may lead to disturbed masticatory function and compromised facial aesthetics. This common clinical disease seriously impairs patient’s physical and mental health. Without immune reaction and donor site injury，distraction osteogenesis is an ideal modality in the reconstruction of condylar defect. Condyle-like structure and morphology can be obtained by precisely adjusting distraction vector and distance. The deficiency of soft tissue can also be corrected in the distraction process. This paper summarizes the application of distraction osteogenesis to the condylar defect reconstruction based on author’s experience and relevant literature，emphasizing the time of treatment， preoperative design and simulation， as well as discussing the intraoperative and post-operative key technical points.