U形截骨术和下颌骨超长弧形截骨术矫正下颌角肥大伴长颏畸形的疗效对比分析

目的:探讨不同术式矫正下颌角肥大伴长颏畸形的应用效果。方法:选取笔者科室2017年1月-2019年1月收治的26例下颌骨肥大伴长颏畸形患者,分别采用U形截骨术和下颌骨超长弧形截骨术两种术式进行矫正,比较两组患者的疗效、术后并发症及满意度情况。结果:U形截骨术组总有效率为90.00%,下颌骨超长弧形截骨术组总有效率为100.00%,下颌骨超长弧形截骨术组总有效率高于U形截骨术组,两组比较差异有统计学意义(P<0.05)。采用U形截骨术后,其中5例患者出现下唇麻木或肿胀,1例有轻微皮肤软组织下垂;采用下颌骨超长弧形截骨术后,其中8例患者口唇有不同程度的麻木或肿胀,1例出现下颌部局部轻度血肿。所有患者均未出现严重并发症,两组患者术后并发症发生情况比较,无统计学差异(P>0.05)。术后6个月对所有患者进行随访,U形截骨术组患者满意度为80.00%,下颌骨超长弧形截骨术组患者满意度为100.00%,下颌骨超长弧形截骨术组满意度高于U形截骨术组,两组比较差异有统计学意义(P<0.05)。结论:相较于传统下颌角截骨术,U形截骨术以及下颌骨超长弧形截骨术均可进一步改善矫正效果,满足患者术前要求。其中,下颌骨超长弧形截骨术具有更佳的矫正效果,并能提高患者对矫正术后的满意度及预后质量。

Comparative Analysis of the Effect of U-shaped Osteotomy and Super-length Arc Osteotomy for the Correction of Mandibular Angle Hypertrophic with Long Chin Deformity

Objective To explore the application effect of different surgical methods to correct mandibular angle hypertrophic with long chin deformity.Methods 26 patients with mandibular angle hypertrophic with long chin deformity were treated in plastic surgery department of our hospital from January 2017 to January 2019 were selected.U-shaped osteotomy and superlength arc osteotomy were used for correction.The efficacy,occurrence of postoperative complications and satisfaction of the two groups were compared.Results The total effective rate of the U-shaped osteotomy group was 90.00%,and the total effective rate of the super-length arc osteotomy group was 100.00%. The total effective rate of super-length arc osteotomy groupwas higher than that of U-shaped osteotomy group, and the difference was statistically signifi cant (P <0.05). After U-shapedosteotomy, 5 cases of patient with lower lip numbness or swelling after operation, 1 cases of patient with slight sagging of softtissue after operation. After super-length arc osteotomy, 8 cases of patient with lower lip numbness or swelling after operation, 1cases of patient with slight local hematoma of mandible after operation. No serious complications occurred in all patients. Therewas no signifi cant difference in the incidence of complications between the two groups (P >0.05). All patients were followedup 6 months after operation. The satisfaction rate of U-shaped osteotomy group was 80.00%, and the satisfaction rate of superlengtharc osteotomy group was 100.00%. The satisfaction of super-length arc osteotomy group was higher than that of U-shapedosteotomy group, and the difference was statistically signifi cant (P <0.05). Conclusion Compared with traditional mandibularangle osteotomy, U-shaped osteotomy and super-length arc osteotomy can further improve the correction effect and meet thepreoperative requirements of patients. Among them, the super-length arc osteotomy has better correction effect, and can improvethe patient's satisfaction and quality of prognosis after correction.