半侧颜面部容积减少性畸形的轮廓重塑与量化评估

来源 :第二十二届中日整形外科学术交流会 | 被引量 : 0次 | 上传用户:yufengdong
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  Objective:To study how to treat reasonably patients with different-level hemi-facial volume-reduced deformityand discuss clinical meaning of quantitative evaluation on facial asymmetrybased on3D-image digital data.Methods: From Jun.2001 to Jun.2013, there are 154 patients with hemi-facial volume-reduced deformity underwent only autologous fat grafting or series of operations.According to maxillofacial bone deformity and deviation of facial central line, all cases were divided into three degrees:mild, moderate and severe.Patients with different-degree deformities were treated by only autologous fat transplantation or series of operations to reshape facial contour.The 3D-image data of facial asymmetry were collected with 3D lasersurface scanning before and after operations and processed with a general reverse engineering softwareto evaluate facial contour quantitatively.Patients were followed with long period and treatment outcome was assessed systemically.Results: For patients with mild and moderate degree deformities, a better therapeutic effect could be achieved only byautologous fat transplantation; while for patients with severe deformities, other operations, such as maxillofacial bone osteotomy or filling procedure, were usually necessary.Each case was injected with autologous fats from1to 5 times with an average 3.1 times.All patients were followed from 1 to 10 years with an average of 3.2 years.Intraoperative actual injection volume of fat was similar to predictive volume.Compare with pre-operation, outcomes of area, volume and thickness of lesions were decreased.139 patients (90.3 %) were very satisfied, 11 patients (7.1%) were satisfied, and 4 patients (2.6%) were unsatisfied.Conclusion: Autologous fat is ideal soft tissue filler in maxillofacial regain.For patients with severe degree deformity, skeletal structure should be usually reshaped combined with autologous fat grafting.The method of 3D image quantitative analysis can provide precise information in treatment planning of volume-reduced deformity and assess therapeutic effect objectively.
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