CAJ | 학술논문

目的：探讨超声骨刀在颧骨颧弓肥大矫正术中各部位骨质截骨的临床应用方法、效果和价值。方法：颧骨颧弓肥大整形就医者30例（男1例，女29例），均采用经鼻腔插管全身麻醉，口内联合耳屏前小切口，骨膜下分离颧骨体部及颧弓后端，注意妥善保护颧神经及面神经颧颞支，采用超声骨刀不同部位截骨和打孔相结合的技术操作。结果：超声骨刀可以准确安全截断颧骨体部及颧弓后端，顺利完成预先设计的各项操作，比传统的截骨工具有着明显的优越性。所有受术者均未出现截骨部位的热损伤、截骨不整齐及软组织损伤现象，术后随访6个月以上，截骨处愈合良好，外形稳定，形态效果满意。结论：采用超声骨刀进行颧骨颧弓肥大矫正术，可较好地提高手术精确度和安全性，但较传统截骨工具（如来复锯及裂钻），超声骨刀截骨时需要掌握一定的操作技巧。
목적：탐토초성골도재권골권궁비대교정술중각부위골질절골적림상응용방법、효과화개치。방법：권골권궁비대정형취의자30례（남1례，녀29례），균채용경비강삽관전신마취，구내연합이병전소절구，골막하분리권골체부급권궁후단，주의타선보호권신경급면신경권섭지，채용초성골도불동부위절골화타공상결합적기술조작。결과：초성골도가이준학안전절단권골체부급권궁후단，순리완성예선설계적각항조작，비전통적절골공구유착명현적우월성。소유수술자균미출현절골부위적열손상、절골불정제급연조직손상현상，술후수방6개월이상，절골처유합량호，외형은정，형태효과만의。결론：채용초성골도진행권골권궁비대교정술，가교호지제고수술정학도화안전성，단교전통절골공구（여래복거급렬찬），초성골도절골시수요장악일정적조작기교。
Objective To evaluate the result of the use of piezosurgery osteotome for treatment of zygoma and zygomatic arch hypertrophy. Methods Under intraoral combined with anterior to tragus approach and general anesthesia,30 patients (1 male patient and 29 female patients) underwent malar reduction with piezosurgery osteotome.The zgyomatic body and posterior end of arch under periosteum was explored and the zygoamtic nerve and facial nerve were protected. According to the clinical features of zygoma and zygomatic arch hypertrophy,L-shaped osteotomy in body,shaped osteotomy in arch end and perforation were performed. Results The osteotomy of malar reduction could be completed with Piezosurgery osteotomy.After 6 months following-up,the out-lines of all cases were natural and concordant.There were no complications of osseous heat injury,soft tissue and nerve injury.Compared with traditional osteotome devices.piezosurgery osteotome was safe and precise. Conclusion piezosurgery osteotome can improve the precision and safety of malar reduction.But compared with traditional osteotomy devices,it need surgery master sufficient skill.