小颏畸形的治疗进展
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摘要
良好的颏部是保证面部和谐的重要部分,在面部轮廓中占有重要地位。小颏畸形的主要表现是颏部短小和后缩,是最常见的颏部畸形。小颏畸形对患者的容貌和心理都有严重影响。小颏畸形一般使用手术方式治疗,常用的手术方式主要包括假体植入隆颏术、颏截骨颏成形术和自体骨移植隆颏术等,各术式分别有其各自的适应症及优缺点。近几年,随着数字化技术应用于小颏畸形的治疗中,外科医师可通过计算机辅助外科手术模拟技术和计算机辅助设计及制造技术,有效地制定个性化的手术方案,从而达到最佳的手术效果,提高医患满意度。
A beautiful chin is an important part of facial harmony and plays an important role in facial contour. The main manifestation of microgenia is that the chin is short and shrinks back, which is the most common chin deformity. microgenia has a serious effect on the appearance and psychology of patients. microgenia is generally treated with surgical methods, which mainly include alloplastic chin augmentation, osseous genioplasty and chin augmentation with autologous bone grafts. Each method has its own indications, advantages and disadvantages. In recent years, with the application of digital technology in the treatment of microgenia, surgeons can make individualized surgical plans through computer-aided surgical simulation technology and computer-aided design and manufacture technology, so as to achieve the best surgical effect and improve doctor-patient satisfaction.
A beautiful chin is an important part of facial harmony and plays an important role in facial contour. The main manifestation of microgenia is that the chin is short and shrinks back, which is the most common chin deformity. microgenia has a serious effect on the appearance and psychology of patients. microgenia is generally treated with surgical methods, which mainly include alloplastic chin augmentation, osseous genioplasty and chin augmentation with autologous bone grafts. Each method has its own indications, advantages and disadvantages. In recent years, with the application of digital technology in the treatment of microgenia, surgeons can make individualized surgical plans through computer-aided surgical simulation technology and computer-aided design and manufacture technology, so as to achieve the best surgical effect and improve doctor-patient satisfaction.
引文
[1]Park S,Noh J.Importance of the chin in lower facial contour:narrowing genioplasty to achieve a feminine and slim lower face[J].Plastic&Reconstructive Surgery,2013,132(5):877E-878E.DOI:10.1097/PRS.0b013e3181774179.
[2]Mccarthy J G,Ruff G L,Zide B M.A surgical system for the correction of bony chin deformity[J].Clinics in Plastic Surgery,1991,18(1):139-152.
[3]Guyuron B,Michelow B J,Willis L.Practical classification of chin deformities[J].Aesthetic Plastic Surgery,1995,19(3):257-264.
[4]邵祯.颏部畸形及治疗[J].中国实用口腔科杂志,2011,04(11):648-652.DOI:10.3969/j.issn.1674-1595.2011.11.003.
[5]Ward J L,Garri J I,Wolfe S A.The Osseous Genioplasty[J].Clinics in Plastic Surgery,2007,34(3):485-500.DOI:10.1016/j.cps.2007.05.009
[6]Terino E O,Edwards M C.Customizing jawlines:the art of alloplastic premandible contouring[J].Facial Plastic Surgery Clinics of North America,2008,16(1):99-122.DOI:10.1016/j.fsc.2007.09.010
[7]Binder W J,Dhir K,Joseph J.The role of fillers in facial implant surgery[J].Facial Plastic Surgery Clinics of North America,2013,21(2):201-211.DOI:10.1016/j.fsc.2013.02.001
[8]杨甄宇,陈小平,林洁.高密度多孔聚乙烯假体在隆颏术中的应用[J].中华医学美学美容杂志,2007,13(4):244-245.DOI:10.3760/cma.j.issn.1671-0290.2007.04.020.
[9]Godin M,Costa L,Romo T,et al.Gore-Tex chin implants:a review of 324 cases[J].Archives of Facial Plastic Surgery,2003,5(3):224-227.DOI:10.1001/archfaci.5.3.224
[10]Warren S,Spector J B.Chin surgery VII:the textured secured implant-a recipe for success[J].Plastic&Reconstructive Surgery,2007,120(5):1378-1385.DOI:10.1097/01.prs.0000279331.65910.75
[11]Yaremchuk M J.Improving aesthetic outcomes after alloplastic chin augmentation[J].Plastic&Reconstructive Surgery,2003,112(5):1422.DOI:10.1097/01.PRS.0000081067.90827.C2
[12]童海洲,赵振民,尹宁北,等.口内双侧横行小切口隆颏术[J].中国美容医学,2012,21(15):1919-1921.DOI:10.3969/j.issn.1008-6455.2012.15.012.
[13]Frodel J L.Evaluation and treatment of deformities of the chin[J].Facial Plastic Surgery Clinics of North America,2002,10(3):221-232.DOI:10.1016/j.fsc.2004.06.001
[14]Hazani R,Rao A,Ford R,et al.The safe zone for placement of chin implants[J].Plastic&Reconstructive Surgery,2013,131(4):869-872.DOI:10.1097/PRS.0b013e3182818e6c
[15]王毅敏,Chek-Hau C,穆雄铮.隆颏术径路及并发症的比较[J].组织工程与重建外科,2007,3(5):273-274.DOI:10.3969/j.issn.1673-0364.2007.05.011.
[16]尹琳,张智勇,石蕾,等.颏部美容成形术相关并发症探讨[J].中华医学美学美容杂志,2015,21(6):371-373.DOI:10.3760/cma.j.issn.1671-0290.2015.06.016.
[17]Strauss R A,Abubaker A O.Genioplasty:A case for advancement osteotomy[J].Journal of Oral&Maxillofacial Surgery,2000,58(7):783-787.DOI:10.1053/joms.2000.7266
[18]Bell W H,Gallagher D M.The versatility of genioplasty using a broad pedicle[J].Journal of Oral&Maxillofacial Surgery,1983,41(12):763-769.
[19]Guyuron B,Raszewski R L.A critical comparison of osteoplastic and alloplastic augmentation genioplasty[J].Aesthetic Plastic Surgery,1990,14(3):199-266.PMID:2399851
[20]Alqattan M,Djordjevic J,Zhurov A I,et al.Comparison between landmark and surface-based threedimensional analyses of facial asymmetry in adults[J].European Journal of Orthodontics,2015,37(1):1-12.DOI:10.1093/ejo/cjt075
[21]Baek R,Han S,Baek S.Surgical correction of the face with the square jaw and weak chin:angle-to-chin bone transfer[J].Plastic&Reconstructive Surgery,2001,108(1):225-231.
[22]Gianni,A.Neurosensory alterations of the inferior alveolar and mental nerve after genioplasty alone or associated with sagittal osteotomy of the mandibular ramus[J].Journal of Cranio-Maxillofacial Surgery,2002,30(5):295-303.
[23]Hwang K.Chin augmentation with a bone graft from the mandibular region[J].Journal of Craniofacial Surgery,2000,11(6):543-546.PMID:11314494
[24]罗金超,归来,张智勇,等.自体下颌骨隆颏术[J].中华整形外科杂志,2004,20(2):104-105.DOI:10.3760/j.issn:1009-4598.2004.02.007.
[25]Whitaker L A.Biological boundaries:a concept in facial skeletal restructuring[J].Clinics in Plastic Surgery,1989,16(1):1-10.
[26]Li M,Lin X,Xu Y.The application of rapid prototyping technique in chin augmentation[J].Aesth Plast Surgery,2010,34(2):172-178.DOI:10.1007/s00266-009-9397-x
[27]Schmelzeisen R,Gellrich N C,Schramm A,et al.Navigation-guided resection of temporomandibular joint ankylosis promotes safety in skull base surgery[J].Journal of Oral&Maxillofacial Surgery,2002,60(11):1275-1283.
[28]Hsu S S,Gateno J,Bell R B,et al.Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery:a prospective multicenter study[J].Journal of Oral&Maxillofacial Surgery,2013,71(1):128-142.DOI:10.1016/j.joms.2012.03.027
[29]Xia J J,Gateno J,Teichgraeber J F,et al.Accuracy of the Computer-Aided Surgical Simulation(CASS)System in the Treatment of Patients With Complex Craniomaxillofacial Deformity:A Pilot Study[J].Journal of Oral&Maxillofacial Surgery,2007,65(2):248-254.DOI:10.1016/j.joms.2006.10.005
[30]Polley J W,Figueroa A A.Orthognathic positioning system:intraoperative system to transfer virtual surgical plan to operating field during orthognathic surgery[J].Journal of Oral&Maxillofacial Surgery,2013,71(5):911-920.DOI:10.1016/j.joms.2012.11.004
[31]De R G,Meloni S M,Baj A,et al.Computer-assisted orthognathic surgery for correction of facial asymmetry:results of a randomised controlled clinical trial[J].Br J Oral Maxillofac Surg,2014,52(3):251-257.DOI:10.1016/j.bjoms.2013.12.010
[32]Gate?o J,Xia J J,Teichgraeber J F.Effect of Facial Asymmetry on Two-Dimensional and ThreeDimensional Cephalometric Measurements[J].Journal of Oral&Maxillofacial Surgery Official Journal of the American Association of Oral&Maxillofacial Surgeons,2011,69(3):655-62.DOI:10.1597/1545-1569_1993_030_0528_iccaid_2.3.co_2
[33]Gateno J,Xia J J,Teichgraeber J F.New Methods to Evaluate Craniofacial Deformity and to Plan Surgical Correction[J].Seminars in Orthodontics,2011,17(3):225-234.DOI:10.1053/j.sodo.2011.02.006
[34]Qiao J,Fu X,Gui L,et al.Computer Image-Guided Template for Horizontal Advancement Genioplasty[J].Journal of Craniofacial Surgery,2016,27(8):2004-2008.DOI:10.1097/SCS.0000000000003093
[35]Xiao Y,Sun X,Lin W,et al.The Application of 3DPrinting Technology for Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty in the Treatment of Craniofacial Deformities[J].Aesthetic Plastic Surgery,2017(6):1413-1424.DOI:10.1007/s00266-017-0914-z
[36]Lin W,Dan T,Sun X,et al.The Precise Repositioning Instrument for Genioplasty and a Three-Dimensional Printing Technique for Treatment of Complex Facial Asymmetry[J].Aesthetic Plastic Surgery,2017,41(4):919-929.DOI:10.1007/s00266-017-0875-2
[37]Li B,Shen S G,Yu H,et al.A new design of CAD/CAM surgical template system for two-piece narrowing genioplasty[J].International Journal of Oral&Maxillofacial Surgery,2016,45(5):560-566.DOI:10.1016/j.i jom.2015.10.013
[2]Mccarthy J G,Ruff G L,Zide B M.A surgical system for the correction of bony chin deformity[J].Clinics in Plastic Surgery,1991,18(1):139-152.
[3]Guyuron B,Michelow B J,Willis L.Practical classification of chin deformities[J].Aesthetic Plastic Surgery,1995,19(3):257-264.
[4]邵祯.颏部畸形及治疗[J].中国实用口腔科杂志,2011,04(11):648-652.DOI:10.3969/j.issn.1674-1595.2011.11.003.
[5]Ward J L,Garri J I,Wolfe S A.The Osseous Genioplasty[J].Clinics in Plastic Surgery,2007,34(3):485-500.DOI:10.1016/j.cps.2007.05.009
[6]Terino E O,Edwards M C.Customizing jawlines:the art of alloplastic premandible contouring[J].Facial Plastic Surgery Clinics of North America,2008,16(1):99-122.DOI:10.1016/j.fsc.2007.09.010
[7]Binder W J,Dhir K,Joseph J.The role of fillers in facial implant surgery[J].Facial Plastic Surgery Clinics of North America,2013,21(2):201-211.DOI:10.1016/j.fsc.2013.02.001
[8]杨甄宇,陈小平,林洁.高密度多孔聚乙烯假体在隆颏术中的应用[J].中华医学美学美容杂志,2007,13(4):244-245.DOI:10.3760/cma.j.issn.1671-0290.2007.04.020.
[9]Godin M,Costa L,Romo T,et al.Gore-Tex chin implants:a review of 324 cases[J].Archives of Facial Plastic Surgery,2003,5(3):224-227.DOI:10.1001/archfaci.5.3.224
[10]Warren S,Spector J B.Chin surgery VII:the textured secured implant-a recipe for success[J].Plastic&Reconstructive Surgery,2007,120(5):1378-1385.DOI:10.1097/01.prs.0000279331.65910.75
[11]Yaremchuk M J.Improving aesthetic outcomes after alloplastic chin augmentation[J].Plastic&Reconstructive Surgery,2003,112(5):1422.DOI:10.1097/01.PRS.0000081067.90827.C2
[12]童海洲,赵振民,尹宁北,等.口内双侧横行小切口隆颏术[J].中国美容医学,2012,21(15):1919-1921.DOI:10.3969/j.issn.1008-6455.2012.15.012.
[13]Frodel J L.Evaluation and treatment of deformities of the chin[J].Facial Plastic Surgery Clinics of North America,2002,10(3):221-232.DOI:10.1016/j.fsc.2004.06.001
[14]Hazani R,Rao A,Ford R,et al.The safe zone for placement of chin implants[J].Plastic&Reconstructive Surgery,2013,131(4):869-872.DOI:10.1097/PRS.0b013e3182818e6c
[15]王毅敏,Chek-Hau C,穆雄铮.隆颏术径路及并发症的比较[J].组织工程与重建外科,2007,3(5):273-274.DOI:10.3969/j.issn.1673-0364.2007.05.011.
[16]尹琳,张智勇,石蕾,等.颏部美容成形术相关并发症探讨[J].中华医学美学美容杂志,2015,21(6):371-373.DOI:10.3760/cma.j.issn.1671-0290.2015.06.016.
[17]Strauss R A,Abubaker A O.Genioplasty:A case for advancement osteotomy[J].Journal of Oral&Maxillofacial Surgery,2000,58(7):783-787.DOI:10.1053/joms.2000.7266
[18]Bell W H,Gallagher D M.The versatility of genioplasty using a broad pedicle[J].Journal of Oral&Maxillofacial Surgery,1983,41(12):763-769.
[19]Guyuron B,Raszewski R L.A critical comparison of osteoplastic and alloplastic augmentation genioplasty[J].Aesthetic Plastic Surgery,1990,14(3):199-266.PMID:2399851
[20]Alqattan M,Djordjevic J,Zhurov A I,et al.Comparison between landmark and surface-based threedimensional analyses of facial asymmetry in adults[J].European Journal of Orthodontics,2015,37(1):1-12.DOI:10.1093/ejo/cjt075
[21]Baek R,Han S,Baek S.Surgical correction of the face with the square jaw and weak chin:angle-to-chin bone transfer[J].Plastic&Reconstructive Surgery,2001,108(1):225-231.
[22]Gianni,A.Neurosensory alterations of the inferior alveolar and mental nerve after genioplasty alone or associated with sagittal osteotomy of the mandibular ramus[J].Journal of Cranio-Maxillofacial Surgery,2002,30(5):295-303.
[23]Hwang K.Chin augmentation with a bone graft from the mandibular region[J].Journal of Craniofacial Surgery,2000,11(6):543-546.PMID:11314494
[24]罗金超,归来,张智勇,等.自体下颌骨隆颏术[J].中华整形外科杂志,2004,20(2):104-105.DOI:10.3760/j.issn:1009-4598.2004.02.007.
[25]Whitaker L A.Biological boundaries:a concept in facial skeletal restructuring[J].Clinics in Plastic Surgery,1989,16(1):1-10.
[26]Li M,Lin X,Xu Y.The application of rapid prototyping technique in chin augmentation[J].Aesth Plast Surgery,2010,34(2):172-178.DOI:10.1007/s00266-009-9397-x
[27]Schmelzeisen R,Gellrich N C,Schramm A,et al.Navigation-guided resection of temporomandibular joint ankylosis promotes safety in skull base surgery[J].Journal of Oral&Maxillofacial Surgery,2002,60(11):1275-1283.
[28]Hsu S S,Gateno J,Bell R B,et al.Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery:a prospective multicenter study[J].Journal of Oral&Maxillofacial Surgery,2013,71(1):128-142.DOI:10.1016/j.joms.2012.03.027
[29]Xia J J,Gateno J,Teichgraeber J F,et al.Accuracy of the Computer-Aided Surgical Simulation(CASS)System in the Treatment of Patients With Complex Craniomaxillofacial Deformity:A Pilot Study[J].Journal of Oral&Maxillofacial Surgery,2007,65(2):248-254.DOI:10.1016/j.joms.2006.10.005
[30]Polley J W,Figueroa A A.Orthognathic positioning system:intraoperative system to transfer virtual surgical plan to operating field during orthognathic surgery[J].Journal of Oral&Maxillofacial Surgery,2013,71(5):911-920.DOI:10.1016/j.joms.2012.11.004
[31]De R G,Meloni S M,Baj A,et al.Computer-assisted orthognathic surgery for correction of facial asymmetry:results of a randomised controlled clinical trial[J].Br J Oral Maxillofac Surg,2014,52(3):251-257.DOI:10.1016/j.bjoms.2013.12.010
[32]Gate?o J,Xia J J,Teichgraeber J F.Effect of Facial Asymmetry on Two-Dimensional and ThreeDimensional Cephalometric Measurements[J].Journal of Oral&Maxillofacial Surgery Official Journal of the American Association of Oral&Maxillofacial Surgeons,2011,69(3):655-62.DOI:10.1597/1545-1569_1993_030_0528_iccaid_2.3.co_2
[33]Gateno J,Xia J J,Teichgraeber J F.New Methods to Evaluate Craniofacial Deformity and to Plan Surgical Correction[J].Seminars in Orthodontics,2011,17(3):225-234.DOI:10.1053/j.sodo.2011.02.006
[34]Qiao J,Fu X,Gui L,et al.Computer Image-Guided Template for Horizontal Advancement Genioplasty[J].Journal of Craniofacial Surgery,2016,27(8):2004-2008.DOI:10.1097/SCS.0000000000003093
[35]Xiao Y,Sun X,Lin W,et al.The Application of 3DPrinting Technology for Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty in the Treatment of Craniofacial Deformities[J].Aesthetic Plastic Surgery,2017(6):1413-1424.DOI:10.1007/s00266-017-0914-z
[36]Lin W,Dan T,Sun X,et al.The Precise Repositioning Instrument for Genioplasty and a Three-Dimensional Printing Technique for Treatment of Complex Facial Asymmetry[J].Aesthetic Plastic Surgery,2017,41(4):919-929.DOI:10.1007/s00266-017-0875-2
[37]Li B,Shen S G,Yu H,et al.A new design of CAD/CAM surgical template system for two-piece narrowing genioplasty[J].International Journal of Oral&Maxillofacial Surgery,2016,45(5):560-566.DOI:10.1016/j.i jom.2015.10.013