目的:评估整块下颌U型截骨术后颈下软组织的变化,并检查腹肌前腹(ABDM)的改变。
方法:一项回顾性研究分析了2018年至2023年20例接受整块下颌U形截骨术的患者。收集术前(Tp)和长期随访(Tf)的CT数据进行分析。测量下颌体积,menton(Mes)和宫颈(C)的软组织厚度,和ABDM参数(长度,横截面积(CSA),volume,从质心点到下颌边缘的距离)。进行相关分析以研究软组织厚度变化之间的联系,ABDM更改,下颌截骨量。
结果:长期随访显示,U型下颌骨截骨术后Mes和C点的软组织厚度显着增加,尤其是在C点。ABDM的自适应长度减小,CSA增加,体积减少,但是ABDM质心点相对于下颌边缘向下移动,表明下垂的突起。软组织厚度的增加与截骨量呈中度正相关,ABDM长度和体积的减少与截骨量呈正相关。
结论:U形截骨术后软组织松弛程度与截骨范围有关。值得注意的是,ABDM相对于下颌缘的突出会影响下颈椎轮廓的美学。在U形截骨之前,评估患者下面部的软组织状况至关重要,截骨体积的个性化设计应谨慎安全地进行。
方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
OBJECTIVE: To assess submental-cervical soft tissue changes after en bloc mandibular U-shaped osteotomy and examine alterations in the anterior belly of digastric muscle (ABDM).
METHODS: A retrospective study analyzed 20 patients who underwent en bloc mandibular U-shaped osteotomy from 2018 to 2023. Preoperative (Tp) and long-term follow-up (Tf) CT data were collected for analysis, measuring mandibular volume, soft tissue thickness at menton (Mes) and cervicale (C), and ABDM parameters (length, cross-sectional area (CSA), volume, distance from centroid point to the mandibular margin). Correlation analyses were performed to investigate the connection between soft tissue thickness changes, ABDM changes, and mandibular osteotomy volume.
RESULTS: Long-term follow-up revealed a significant increase in soft tissue thickness at the Mes and C points after U-shaped mandibular osteotomy, especially at the C point. The adaptive length of ABDM decreased, CSA increased, and volume decreased, but the ABDM centroid point shifted downward relative to the mandibular margin, indicating drooping protrusion. The increment of soft tissue thickness was moderately positively correlated with the amount of osteotomy, and the decrement of ABDM length and volume were slightly positively correlated with the amount of osteotomy.
CONCLUSIONS: The degree of soft tissue relaxation after U-shaped osteotomy is related to the extent of osteotomy. Notably, the protrusion of ABDM relative to the mandibular margin affects submental-cervical contour aesthetics. Prior to U-shaped osteotomy, it is crucial to assess the soft tissue condition of the patient\'s lower face, and the individualized design of the osteotomy volume should be carried out cautiously and safely.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .