CAJ | 학술논문

目的测量分析头皮冠状切口术后软组织变化,探讨其发生机制和预防措施.方法选取2003年3月至2008年9月经半头皮冠状切口行单侧颧骨粉碎性骨折手术,且均随访1年以上并有完整的临床及影像学资料的33例患者进行回顾性分析,对33例患者颧骨三维CT、颧面部、顾部的外形测量所得数值,包括健、患两侧差值等进行比较分析.结果颞部最凹点健、患侧软组织厚度差值为(1.60±0.97)mm,其中12例差值大于2 mm,健、患两侧软组织厚度有显著性差异(P＜0.01);颧点表面健、患侧软组织厚度差值为(0.68±0.48)mm,差值大于2 mm 1例,两侧比较差异无统计学意义(P＞0.05);颧突点、颧颌点及颞部最凸点表面软组织厚度差异均小于2 mm,两侧比较差异无统计学意义(P＞0.05).结论头皮冠状切口术后颧面部软组织厚度无明显改变,颞部脂肪垫处软组织均有不同程度的萎缩,部分导致不对称畸形.术中应注意解剖层次,保护血管,避免过分牵拉,以尽量减少术后畸形的发生.
목적 측량분석두피관상절구술후연조직변화,탐토기발생궤제화예방조시.방법 선취2003년3월지2008년9월경반두피관상절구행단측권골분쇄성골절수술,차균수방1년이상병유완정적림상급영상학자료적33례환자진행회고성분석,대33례환자권골삼유CT、권면부、고부적외형측량소득수치,포괄건、환량측차치등진행비교분석.결과 섭부최요점건、환측연조직후도차치위(1.60±0.97)mm,기중12례차치대우2 mm,건、환량측연조직후도유현저성차이(P＜0.01);권점표면건、환측연조직후도차치위(0.68±0.48)mm,차치대우2 mm 1례,량측비교차이무통계학의의(P＞0.05);권돌점、권합점급섭부최철점표면연조직후도차이균소우2 mm,량측비교차이무통계학의의(P＞0.05).결론 두피관상절구술후권면부연조직후도무명현개변,섭부지방점처연조직균유불동정도적위축,부분도치불대칭기형.술중응주의해부층차,보호혈관,피면과분견랍,이진량감소술후기형적발생.
Objective To investigate the change of zygomatic and temporal soft tissue after coronal incision. Methods A retrospective analysis was performed in 33 patients who received firm fixation for unilateral zygomatic comminuted fracture through semi-coronal incision. All the patients were followed up for more than one year. Craniofacial anthropometric measurement through 3D-CT reconstruction and facial profile was performed. The difference between the operated side and healthy side was analyzed. Results At the temporal concave point, the soft tissue thickness at healthy side was(1.60 ±0. 97)mm more than that at operated side, showing a significant difference between them (P ＜ 0. 01). While the soft tissue thickness was not statistically different between two sides at zygion, malar prominence, zygomaxillare, and temporal convex point(P ＞ 0. 05). Conclusions The soft tissue atrophy may happen at temporal fat pad after semi-coronal incision, but not at zygomatic area. Intraoperative precise dissection and less stretch of soft tissue may be helpful to avoid the postoperative facial asymmetry.