Clinical effects of platelet rich fibrin in prevention of bleeding and swelling after mandibular angle reduction / 中华医学美学美容杂志

Objective To observe the clinical effect of platelet-rich fibrin (PRF) on prevention of postoperative hemorrhage and facial traumatic swelling in patients with mandibular angle osteotomy.Methods Twenty-five patients with mandibular angle hypertrophy were included in this study from January 2014 to November 2015.Split face comparative study was carried out to use the left and right sides as the experimental side and the control side,respectively.The PRF in the experimental side was placed in the mandibular osteotomy,while the control side was placed in platelet-poor plasma (PPP).After operation,the drainage volume and facial swelling degree were measured.Results The drainage volume of the experimental group (PRF group) was (20.35 ±7.40) ml,the control group (PPP group) was (43.23±11.96) ml,and the difference was statistically significant (P＜0.05).There was no such case without swelling in postoperative third day.The facial swelling score on the experimental side was (1.19±0.40),the control side was (2.62±0.64),and two groups of postoperative facial swelling scores were significantly different (P＜0.05).Conclusions The PRF can reduce postoperative bleeding and facial swelling after mandibular angle osteotomy.

The postoperative trismus, nerve injury and secondary angle formation after partial masseter muscle resection combined with mandibular angle reduction: a case report

A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.

Mandibular Angle Reduction By Selective Extraoral Approach

For the aeshetic contouring of prominent mandibular angle, conventional resection of mandible angle through intraoral approach has been used commonly. And the sagittal resection of lateral cortex is being performed recently to reduce the lower width of square face in some cases. That is to say, the prominent mandibular angle is meant by not only posteroinferior projection as well as lateral bulging. But intraoral approach corrects the former more efficiently than the latter because of limited operation field. And sometimes, the conventional resection of the mandibular angle yields obtuse, unnatural angle. Still more, postoperative complications such as bleeding, swelling, pain are inescapable. Through extraoral approach, authors were simultaneously able to accomplish precise, sufficient resection of angle and sufficient burring of lateral cortical bone without difficulty and complication. With the incision along relaxed skin tension line and meticulous everted sutures, scars are acceptable. One patient needed scar revision afterward. And so it is reported with review of literatures.