Monobloc四段式截骨牵引治疗眶距增宽症合并面中部发育不良 |
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引用本文: | 侯瑞,韦敏,袁捷,俞哲元.Monobloc四段式截骨牵引治疗眶距增宽症合并面中部发育不良[J].组织工程与重建外科,2013,9(2):102-105. |
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作者姓名: | 侯瑞 韦敏 袁捷 俞哲元 |
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作者单位: | 200011,上海市 上海交通大学医学院附属第九人民医院整复外科 |
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摘 要: | 目的 Monobloc四段式截骨及外置式牵引,治疗1例重度眶距增宽症合并面中部发育不良患者,总结手术方法和经验体会.方法 对1例重度眶距增宽症合并面中部发育不良患者行颅内外联合径路手术.额部颅骨开窗,Monobloc截骨游离整个颅面部,颧颌部水平截骨、眶鼻部矢状截骨,将颅面骨分为额部、双侧眶颧部、颧颌部4段完全游离的骨块,额部重塑,双侧眶颧部内收,肋骨隆鼻,颧颌部外置式牵引并固定3个月.结果 手术顺利,拆除牵引器1个月后,影像学测量显示IOD为28.6 mm、面中部前移约9 mm,患者眶距增宽、面中部凹陷、反(牙合)均得到有效纠正,但鼻形态需进一步修整.结论 Monobloc四段式截骨及外置式牵引治疗重度眶距增宽症伴面中部发育不良,能一次性纠正眶距过宽、面中部凹陷、反(牙合),安全有效.
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关 键 词: | 眶距增宽 面中部发育不良 Monobloc截骨术 牵引 |
Four-Segments Monobloc Osteotomy and External Distraction in the Treatment of Orbital Hyperteiorism withMidface Hypoplasia t |
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Authors: | HOU Rui WEI Min YUAN Jie YU Zheyuan |
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Institution: | (Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai fiaotong University School of Medicine, Shanghai 201211, China) |
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Abstract: | Objective To explore the efficacy of the modified monobloc osteotomy method and external distraction in the treatment of orbital hypertelorism with midfaee hypoplasia. Methods A 19-year-old girl was performed modified monobloc osteotomy through combined intra and extra cranial way. The craniofaeial bone was divided into frontal, two orbital-malar and malar-maxillary segments. The frontal bone was reshaped and the interorbital distance (IOD) got reduced. Self-rib was implanted to rebuild nose. The external distractor was used to advance the malar-maxillary part and the consolidation period lasted for 3 months. Results Well eraniofacial appearance was achieved in this case. The post-operation IOD was 28.6 mm. The real distraction distance of facial bone was 9 mm documented by 3D-CT. However, additional rhinoplasty would be nee- essary for better nasal appearance. Conclusion The modified Monobloe osteotomy method could be applied for severe or- bital hypertelorism with midface hypoplasia. It is a safe technique and can correct orbital hypertelorism, depression of mid- face and mandible prognathism. |
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Keywords: | Orbital hypertelorism Midface hypoplasia Monobloc osteotomy Distraction |
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