[摘要]目的：应用三角块截骨、外板去除和咬肌修薄联合颏部截骨治疗严重方脸畸形。方法：应用口内入路，改良的下颌骨矢状劈开去除外板、摆动锯去除下颌角和咬肌修薄矫正下颌角咬肌肥大，颏部截骨前下移动，取下的下颌骨块充填固定矫正颏部短小。结果：应用该方法治疗严重方脸畸形7例，效果良好，脸型改善明显。结论：三角块截骨、外板去除和咬肌修薄联合颏部整形对矫正严重方脸畸形具有良好的效果。
[关键词]下颌角；整形；颏成型
[中图分类号]R782.2 [文献标识码]A [文章编号]1008-6455（2005）06-0713-02
Correction of the square face by resection of excess masseter muscle and removal of hyperostotic bone from angle of the mandible and chin osteotomy by the intraoral approach
CHEN Yong, CHEN Shou-zheng, YUAN Lei
(The Center of Plastic and Cosmetic Surgery, Shuguang Hospital, Shanghai 200021,China)
Abstract： Objective TO treat the deformity of square face by resection of severe hypertrophic masseteric muscle and mandible outer cortex and angle combined chin osteotomy. Methods The mandible outer cortex were rescted by modified mandible split osteotomy,and mandible angle by oscilating saw,and escess masseteric muscle by scissor.The horizontal osteotomy was combined with an interpositon bone graft for vertical elongation of the anterior portion of the mandible and for increasing the prominence of the chin.All were done by intraoral approach. Results Seven patients with hypertrophic masseter muscle and bony exostosis of mandible and short chin were treated using the method,and good results were achieved, and the patients had beautiful facial contour. Conclusion Combined resection of mandible outer cortex and angle and masseter muscle to treat severe masseteric muscle hypertrophy and bony exostosis of mandible combined with genioplasty could achieve good result for improving square face.
Key words: mandible angle; plastic; genioplasty
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