CAJ | 학술논문

目的：通过手术方法预防下颌角截骨手术后下颌软组织松垂，观察手术效果，探讨更有效的手术方式。方法对18例下颌角方大患者同期行下颌角截骨术及颏下颌下颈阔肌成形术，纠正患者下颌角方大及预防颏下颌下脂肪堆积、松垂。结果所有患者术后随访半年至2年，无1例面神经下颌缘支损伤致下唇歪斜；所有患者张口度正常；术后16例患者对术后外形比较满意；1例患者术后感染后取出提升线；1例患者颏下颌下仍较肥厚松垂，效果不明显。结论颏下颌下颈阔肌成形术在下颌角截骨术中同期施行对下颌角方大患者面部轮廓改善效果良好，安全可靠，同时面部神经血管丰富，术者应熟悉其分布走行，重视钝性分离，不断积累手术经验及操作技巧才能达到满意的手术效果。
목적：통과수술방법예방하합각절골수술후하합연조직송수，관찰수술효과，탐토경유효적수술방식。방법대18례하합각방대환자동기행하합각절골술급해하합하경활기성형술，규정환자하합각방대급예방해하합하지방퇴적、송수。결과소유환자술후수방반년지2년，무1례면신경하합연지손상치하진왜사；소유환자장구도정상；술후16례환자대술후외형비교만의；1례환자술후감염후취출제승선；1례환자해하합하잉교비후송수，효과불명현。결론해하합하경활기성형술재하합각절골술중동기시행대하합각방대환자면부륜곽개선효과량호，안전가고，동시면부신경혈관봉부，술자응숙실기분포주행，중시둔성분리，불단적루수술경험급조작기교재능체도만의적수술효과。
Objective To observe the effects of preventing through operation the soft tissue sag after mandibular angle osteotomy ,and to explore more effective operation methods .Methods 18 patients with the prominent mandibular angle were treated by mandibular angle osteotomy combined with submentum and submaxilla platysma plasty in order to improve the shape of prominent mandibular angle and prevent mandibular parenchyma sag .Results During the follow-up period of six months to two years ,no patients suffered from in-juries in the marginal mandibular branch of the facial nerve which may cause lower lip skew .Mouth opening of all patients was normal . 16 patients were satisfied with their postoperative appearance .As to the remaining two patients ,the lifting line was taken out from one because of postoperative infection ,and postoperative effect was not obvious for the other since submentum and submaxilla was consid -ered still hypertrophic and sagging .Conclusions Mandibular angle osteotomy combined with submentum and submaxilla platysma plasty can improve properly and safely the facial shape of patients with prominent mandibular angle .Because the face is rich in nerves and vessels,operators must be familiar with their distribution ,pay attention to blunt dissection and keep accumulating experience and surgical skills so as to obtain satisfactory operation results .