PDF(Pubmed)
Abstract：
Background: The current high standards in orthognathic surgery demand surgical solutions that are both functionally effective and aesthetically pleasing. Our approach offers one for enhanced stability, attractiveness, and nerve protection with improved accessibility in the majority of orthognathic scenarios compared to an inverted L osteotomy. Methods: A case series is presented to illustrate the application and outcomes of HSSO, an optimised approach that combines the advantages of a transoral inverted L osteotomy with specific enhancements and increased versatility, with accessibility and exposure similar to a BSSO. Results: HSSO as a completely transoral technique, demonstrate the ability to perform significant counterclockwise rotations of the mandible, eliminating the need for trocars or skin incisions. We experinced high postoperative stability when HSSO was performed in conjunction with a three-piece LeFort 1 osteotomy on a dynamic opposing arch. In comparison to an inverted L approach, we postulated that HSSO offers advantages in stability, due to the increased segmental overlap of the proximal and distal segments of the mandible. This approach is designed to enhance the safety of the inferior alveolar nerve compared to traditional sagittal split methods. Furthermore, HSSO represents an alternative to total joint replacement in select cases of idiopathic condylar resorption and is effective for correcting mandibular asymmetries while maintaining jawline aesthetics. This is achieved through the manipulation of the mandibular angle, ramus height, and inferior border without creating a step deformity in the soft tissue. Conclusions: The outcomes of HSSO highlight its capacity to deliver predictable, functional, and aesthetically pleasing results, offering a viable alternative to more traditional orthognathic techniques.
摘要：
背景：当前正颌手术的高标准要求既要有效又要美观的手术解决方案。我们的方法提供了一种增强稳定性的方法，吸引力,与倒L型截骨术相比，在大多数正颌情况下，神经保护能力得到改善。方法：提供一系列案例来说明HSSO的应用和结果，一种优化的方法，结合了经口倒L型截骨术的优势，具有特定的增强功能和增加的多功能性，与BSSO相似的可及性和曝光率。结果：HSSO作为一种完全经口的技术，展示了下颌骨进行显著逆时针旋转的能力，消除了套管针或皮肤切口的需要。当在动态相对牙弓上进行HSSO与三件式LeFort1截骨术时，我们发现术后稳定性很高。与倒L方法相比，我们假设HSSO在稳定性方面具有优势，由于下颌骨近端和远端段的节段重叠增加。与传统的矢状分裂方法相比，该方法旨在增强下牙槽神经的安全性。此外，在特发性con突吸收的某些情况下，HSSO是全关节置换的替代方法，可有效纠正下颌不对称性，同时保持下颌美观。这是通过操纵下颌角实现的，拉姆高度,和下边界，而不会在软组织中造成台阶畸形。结论：HSSO的结果突出了其提供可预测、功能，和美观的结果，为更传统的正颌技术提供了可行的替代方案。
