局部麻醉下口内入路面下部轮廓整形术

目的探索一种不截骨、操作简便、安全、损伤小的面部轮廓整形术。方法局部麻醉下行口内入路不截骨,根据下颌骨的不同类型,用带保护套的高速旋转锉,磨削下颌骨升支的下半部、下颌角及下颌体、颏部的外侧及下缘。同时单独或联合采用隆颏、去除部分颊脂肪垫、去除部分咬肌等综合方法,来重塑面下部轮廓。结果自2001年以来,共收治92例患者,其中下颌骨肥大者34例,同时去除部分咬肌者7例;单独或联合进行隆颏者56例;部分去除颊脂肪垫者17例。术后随访6~24个月,医患双方均满意。结论运用以上术式,进行个性化面下部轮廓整形,具有操作简便、去骨安全、并发症少、恢复快等优点,易于临床推广应用。

Lower facial reconstruction through intraoral approach under local anesthesia

Objective To study a simple, safe and microlesion surgical technique for the lower facial reconstruction without osteotomy. Methods According to the different types of mandible, the lower facial reconstruction trough intraoral approach under local anesthesia was performed without osteotomy by grinding the lower part of ascending ramus of mandible, body and angle of mandible, lateral and lower border of chin with high spinning file with bracer based on the specific type of mandible. For the chin angmentation, partial extraction of buccal fat pads and hypertrophied masseters were performed jointly or alone to reshape the facial contour.Results Ninety-two cases had been performed the operation since 2001, 34 cases were simply treated because of hypertrophy of mandible, among them 7 cases were conducted with partial extraction of masseters simultaneously; 56 cases were treated jointly or alone with chin augmentation; 7 cases were removed partially the buccal fat pads. After 6-24 months following up, all patients were satisfactory without serious complications. Conclusion This operative method is simple, safe and characterized with few complications, quick recovery and better contour.