先天性肌性斜颈儿童颌面部结构形态对称性分析

目的分析先天性肌性斜颈患者颌面部对称性，探讨颈部肌肉功能异常对儿童颌面部生长发育的影响。方法选择替牙期先天性肌性斜颈患者20例（男14，女6），拍摄头颅后前位定位X线片，测量分析双侧颌面结构形态、位置的对称性。结果面中部、面下部中线均偏向患侧（P〈0．01），患侧面部高度、上颌骨垂直高度、下颌骨体长度均较对侧小（P〈0．01），乳突发育优于对侧；患侧髁突、颧弓较对侧偏外（P〈0．01），颧弓相对于颞部塌陷（P〈0．01）；同时发生下颌骨向患侧的旋转移位，加重了下颌骨的不对称畸形。结论先天性肌性斜颈可以导致儿童早期发生颌面部发育不对称，颈部结构与功能对儿童颌面部的生长发育有重要的影响。

Maxillofacial deformity in patients of mixed dentition with uncorrected congenital muscular torticollis

Objective To evaluate maxillofacial symmetry in patients with congenital muscular torticollis at mixed dentition stage.Methods A total of 20 patients with congenital muscular torticollis from 6 to 12 years of age were included.Postero-anterior cephalometirc radiographs were taken to analyze maxillofacial asymmetry.Results Our study demonstrated that the maxillofacial asymmetry occurred in patients with congenital muscular torticollis,characterized by the deviation of ANS point and chin point to the affected side.Comparing with the opposite side,the face height, the maxillary vertical height and the length of the mandibular body on the affected side were smaller,while the development of mastoid process was obviously superior to the opposite side.In symmetric analysis of the position, we detected that on the affected side,the positions of condyle and zygomatic arch were outward than the contralateral side.Meanwhile,in patients with congenital muscular toricollis,the positions of mandible landmarks on both sides changed asymmetrically, which made the vertical height on the affected side decreased more significantly.Conclusions Maxillofacial deformity will develop if the muscle restrication is not released in patients with congenital muscular torticollis.Our study indicates that the neck struckure and function play an important role in the maxillofacial development.