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目的探讨颧骨颧弓梭形截骨内推钛钉锚定术治疗颧骨颧弓肥大的临床效果。方法 2011年7月-2015年1月,采用颧骨颧弓梭形截骨内推钛钉锚定术,对58例高颧弓患者在盲视下行颧骨颧弓缩小整形。其中男3例,女55例;年龄18~33岁,平均23岁。均为先天性双侧颧骨颧弓肥大。术前摄头面部正位、侧位、仰位、45°斜位照片,并行面部三维CT重建,其中单纯性颧骨肥大30例,颧骨肥大伴颧弓突出28例;颧骨颧弓对称51例,不对称7例。结果术后患者切口均Ⅰ期愈合,无感染、血肿发生。4例出现并发症,其中2例上唇麻木,1例张口受限,1例鼻唇沟加深,均于术后3个月左右自行恢复。58例均获随访,随访时间6~12个月,平均10个月。颧骨间距缩窄10.6~13.9 mm,平均11.2 mm。无面部软组织下垂、颧骨台阶感、面神经损伤,抬眉、闭眼功能障碍及颞下颌关节紊乱综合征等发生。术后骨愈合良好,颧面部感觉无明显异常,所有患者对外观改善均满意。结论颧骨颧弓梭形截骨内推钛钉锚定法可有效缩小颧骨并保持颧骨颧弓的自然曲线,手术方法简便、并发症少、固定稳固,是一种较理想的颧骨颧弓缩小整形术。
Objective To investigate the clinical effect of zygomatic arch zygomatic arch shuttle osteotomy and titanium nail anchoring in the treatment of zygomatic arch zygomatic arch hypertrophy. Methods From July 2011 to January 2015, a total of 58 patients with high zygomatic arch underwent zygomatic arch zygomatic arch reduction and reduction under the condition of zygomatic arch zygomatic arch osteotomy with titanium nail anchoring. Including 3 males and 55 females; aged 18 to 33 years, mean 23 years. Congenital bilateral zygomatic arch are bilateral hypertrophy. There were 30 cases of simple zygomatic hypertrophy, 28 cases of zygomatic mastoid protrusion with zygomatic arch, 28 cases of zygomatic arch symmetry 51 cases, 7 cases of asymmetry. Results All incisions were healed by first intention without infection and hematoma occurred. In 4 cases, complications occurred. Among them, 2 cases of upper lip numbness, 1 case of limited mouth opening and 1 case of nasolabial fold deepened, both of which recovered on their own after 3 months. 58 cases were followed up for 6 to 12 months with an average of 10 months. Zygomatic distance narrowed 10.6 ~ 13.9 mm, an average of 11.2 mm. No facial soft tissue sagging, zygomatic level sensation, facial nerve injury, raising eyebrows, eye closure dysfunction and temporomandibular joint disorder syndrome. Postoperative bone healing is good, no obvious abnormality of the zygomatic facial feeling, all patients are satisfied with the appearance of improvement. Conclusions The zygomatic arch zygomatic arch fossil osteotomy with titanium nail anchoring method can effectively reduce the zygomatic arch and maintain the natural curve of the zygomatic arch of the zygomatic arch. The surgical method is simple, less complicated and stable, and is an ideal cheekbones Bow reduction surgery.