摘要
目的探讨先天性及发育性一侧颜面发育不良或萎缩所致颅颌面双侧不对称畸形的综合手术治疗。方法针对患者的畸形情况,设计相应的手术方案以重建患侧的外形及功能。骨骼畸形不明显而主要为软组织萎缩凹陷者,可采用软组织移植的手段予以充填修复;对同时伴有颅面骨骼发育不良的患者,首先重建面部的骨骼支架,在此基础上,再进一步完成软组织的修复。结果1998年9月至2004年8月,共治疗各种原因导致的双侧颜面不对称畸形患者42例,其中单侧颅面短小畸形22例,进行性半侧颜面萎缩16例,肿瘤切除后放疗导致的邻近区域软组织及骨骼的发育不良4例。男18例,女24例。年龄16～38岁,平均24岁。2例肿瘤术后放疗患者,因局部软组织条件差,发生钛板及植入骨外露,1例单侧颅面短小畸形患者采用自体下颌骨外板及肋骨行下颌升支重建后发生感染,致手术失败,其余患者双侧不对称畸形均获得明显改善。结论单侧颜面发育不良或萎缩所致颅颌面双侧不对称畸形,是临床上常见且治疗难度较大的一组畸形,畸形轻重程度不等,涉及软组织和骨组织的治疗。需根据患者的具体情况,合理设计手术方案,综合运用整形及颅颌面外科技术分期手术重建,方可达到最大程度改善外形、恢复功能的目的。
Objective To study the surgical reconstruction of unilateral Craniofacial Atrophy and Hypoplasia. Methods According to the etiological facters and severity of the facial deformities, different methods are employed, including bone framework reconstruction, soft tissue transplantation, orthognathic surgery. Results From September 1998 to August 2004, 42 cases were treated, Include： Hemifacial Microsomia 22cases, Hemifacial Atrophy 16cases, unilateral facial hypoplasia due to radiation 4cases. miniplate and transplants extrusion occurredon 2 post radiation patients due to poor soft tissue coverage, infection occurred on 1 patient after mandibular ramus reconstruction using autogenous rib and controlateral mandibular outer cortex. The leaving patients recovered well and the facial asymmetery were improved greatly. Conclusions Facial asymmetry due to unilateral Craniofacial Atrophy or Hypoplasia is a common and complex condition for surgical management, The surgical plan should be delicated made individually according to the severity of the soft tissue and the underlying bone framework.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2006年第2期99-102,共4页
Chinese Journal of Plastic Surgery
