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目的探讨CT三维重建技术在治疗下颌角肥大中的临床指导意义。方法 2009年3月-2011年1月在CT三维重建技术指导下行下颌骨截骨术治疗下颌角肥大18例。患者均为女性;年龄20～36岁,平均25岁。单纯下颌角肥大14例;伴咬肌肥大3例,双侧不对称1例。下垂型6例,外翻型9例,内翻型3例。根据下颌角肥大分型选择合适的手术方法。术前在三维重建工作站上设计并模拟手术过程,标记截骨线及测量截骨量。结果术中无下颌骨骨折发生。术后出现面神经暂时性麻痹1例,3个月后恢复正常。患者均获随访,随访时间6～12个月,平均7.6个月。术后6个月获满意15例,基本满意2例,不满意1例(双侧不对称)。结论根据CT三维重建技术得到头颅三维模型行术前设计可以提高手术准确性,以达到设计的预期效果。
Objective To investigate the clinical significance of CT three-dimensional reconstruction in the treatment of mandibular angle hypertrophy. Methods From March 2009 to January 2011, 18 cases of mandibular angle hypertrophy underwent mandibular osteotomy under the guidance of CT three - dimensional reconstruction. Patients were female; aged 20 to 36 years, mean 25 years. Simple mandibular angle hypertrophy in 14 cases; with masseter hypertrophy in 3 cases, bilateral asymmetry in 1 case. Droop in 6 cases, valgus 9 cases, varus 3 cases. According to the mandibular angle hypertrophy type select the appropriate surgical methods. Preoperative design and simulation of three-dimensional reconstruction workstation on the surgical process, mark the osteotomy line and measure the amount of osteotomy. Results No mandibular fractures occurred during operation. One case of transient facial paralysis occurred after 3 months and returned to normal. All patients were followed up for 6 ~ 12 months with an average of 7.6 months. Six months after operation, 15 patients were satisfied, 2 patients were basically satisfied, and 1 patient was dissatisfied (bilateral asymmetry). Conclusions The preoperative design of cranial three-dimensional model based on CT three-dimensional reconstruction technique can improve the accuracy of the operation in order to achieve the desired effect of the design.