摘要
目的亚洲人大多颧部高突有碍美观,故颧部缩小术在亚洲非常普遍。相关手术方法有多种,但每种方法都有不足。文中建立一种安全有效的颧部缩小手术方法。方法回顾性分析2008年12月至2012年8月在韩国建国大学医院整形科的1652例病例资料,所有患者均因单纯的美容因素行颧部缩小术,首先行局部麻醉,手术切口位于双侧耳前鬓角内,长1.3～1.5 cm。所有分离均位于骨膜下斜下分离,达颧骨体。通过磨削颧骨体外侧骨皮质、凿除颧弓骨皮质和于颞颌关节前部垂直方向全层离断颧弓缩小颧骨。颧骨体外侧指压造成不全骨折引起颧弓移位,自切口留置负压引流,间断缝合封闭切口,并适当加压包扎。结果 2例患者抱怨术后颧部仍然突出,予以经口二次整复。3例出现短暂的单侧眉下垂,术后2月自行恢复。2例出现术后疼痛及张口受限,很快自愈。1例耳前瘢痕明显,术后通过整复得以改善。无一例出现颊部下垂。结论该手术方法,与传统的手术比较,具有简便、安全、并发症少等优点,尤其适用于外侧颧部高突的患者。
Objective Many Asians have the faces with prominent zygomas, therefore reduction malarplasty is one of the most frequently undergone surgeries in Asia. There are various surgical approaches, but few can provide satisfactory outcomes. We de- termined a reduction technique that is the most effective, safest and with the lowest morbidity. Methods From December 2008 to August 2012, 1652 patients who wanted to undergo zygoma reduction for purely aesthetic reasons were operated on using a novel tech- nique that we have developed. Among these patients, the most common age was 30 years old, especially women （female： male 1601：51 ）. First, under local anaesthesia, a 13- to 15-mm-long skin incision is made at each sideburn. The subperiosteal dissection is continued anteriorly all the way to the body of the zygoma. Zygoma reduction is then performed in three steps ： malar shaving （lateral area of the zygoma body）, lateral corticotomy （zygomatic arch） and full-thickness osteotomy （pretubercular area of the temporomandib- ular joint）. Next, the zygomatic arch is displaced medially with digital pressure （infracture）. Finally, a Silastic drain is inserted through the incision, skin repair is completed and a gentle compressive dressing is applied. Results Most of the patients were sub- jectively satisfied with the results of the operation, but secondary revisions were made using the intraoral approach in two patients who complained of undercorrection of their prominent zygomas. Temporary unilateral eyebrow ptosis occurred in three patients, but the pto- sis spontaneously subsided within 2 months postoperatively. Limitation and pain on mouth opening occurred in two cases, but these were also improved shortly after surgery. Only one patient complained of a unilateral preauricular scar on the drain site. This was re- solved by scar revision. There was no case of cheek drooping. Conclusion The presented technique is simpler, more effective, and with fewer complications than previously described surgical tec
出处
《医学研究生学报》
CAS
北大核心
2013年第8期819-822,共4页
Journal of Medical Postgraduates
关键词
缩小术
颧部整形
颧部高突
单一耳前切口
Reduction
Malarplasty
Prominent zygoma
Single preauricular incision
