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目的对颌面部不同原因造成的不同大小凹陷畸形用自体脂肪组织充填进行回顾性分析总结。方法对凹陷畸形的病因进行分类,大致分为先天性发育畸形、后天原因两大类,后天病因又分为半侧颜面萎缩、手术与外伤、脉管疾病等所造成的凹陷畸形。针对上述不同原因和凹陷的大小采用不同方法进行充填。先天畸形者一般采用自体脂肪颗粒进行充填,缺损多者用自体真皮脂肪组织瓣充填;半侧颜面萎缩、手术与外伤者采用真皮脂肪组织瓣结合脂肪颗粒进行充填,而对于静脉畸形造成的凹陷缺损要用真皮脂肪组织瓣充填。结果先天畸形病人由于存在骨骼发育不足,单纯自体脂肪充填有时不足以完全矫正不对称畸形,需要同时矫正骨畸形才能得到较好的临床效果;半侧颜面萎缩病人经过多次充填之后、外貌得到明显改善;手术或外伤之后的凹陷畸形在松解疤痕挛缩的同时进行真皮脂肪组织或脂肪颗粒移植术,可取得较理想临床效果。静脉畸形病人用真皮脂肪组织充填也可获得理想临床效果。结论颌面部缺损凹陷畸形的整形治疗需要根据凹陷畸形的病因、患者的年龄、缺损面积的大小等,采用不同的方式进行脂肪组织充填、才能取得较好的临床效果。
Objective To retrospectively summarize the different sizes of dent deformities caused by different causes of maxillofacial region with autologous adipose tissue filling. Methods The causes of depression deformity were classified into two categories: congenital malformations and acquired causes, and acquired causes were divided into facial deformities caused by facial atrophy, surgery and trauma, and vascular diseases. For different reasons and the size of the depression using different methods for filling. Congenital malformations are generally used to fill the body with autologous fat particles, defects were mostly filled with autologous dermal adipose tissue flap; half facial atrophy, surgery and trauma patients with dermal adipose tissue flap with fat particles filling, and for venous malformations caused by depression Use dermal adipose tissue flap to fill. Results Patients with congenital malformation due to the lack of bone development, simple autologous fat filling is sometimes not enough to completely correct the asymmetric deformity, the need for simultaneous correction of bone deformity in order to get better clinical results; half face atrophy patients after repeated filling, the appearance was obvious Improve; surgical or traumatic deformity after the deformity in the release of scar contracture dermal adipose tissue or fat graft, can achieve better clinical results. Patients with venous malformations with dermal adipose tissue filling can also obtain the desired clinical effect. CONCLUSIONS: Orthopedic treatment of maxillofacial defects and deformity deformity requires that different methods be used to fill the adipose tissue according to the etiology of the deformity, the age of the patient and the size of the defect, so as to achieve better clinical results.