ABSTRACT
Objective To explore the clinical effect of endoscopic-assisted intraoral reduction mandibuloplasty.Methods From January 2010 to December 2014,a total of 186 patients with prominent mandibular angles underwent one stage long-curved ostectomy combined with splitting corticectomy through an intraoral approach with endoscopic assistence according to preoperative design for reduction mandible three-dimensionally,and achieved reduced width of the lower face with smooth curve of mandibular edge.The distance between both gonions was measured and the complications recorded to evaluate the clinical effect of the surgery during follow-up.Results All the 186 patients had no complications of bleeding and infection.The mean distance between both gonions measurement was (117.3±2.5) mm before surgery and (102.6±2.3) mm after operation;it was reduced (14.1 ±2.4)mm.After 1 month to 2 years of follow up,the width of the lower face was reduced in the frontal view and the mandibular angle appeared natural and inconspicuous in the lateral view.The patients were satisfied with both their frontal and lateral appearances.Conclusions Intraoral approach mandibular ostectomy with endoscopic-assisted allows surgeons to perform accurate,safe and reproducible ostectomies and to recontour mandible symmetrically and reduce the complications.
ABSTRACT
Objective To search for a procedure for correction of square face. Methods 68 patients with square face (aged from 21～40 years, with 65 females and 3 males) underwent osteetomy combined mandibular angle triangle resection with lateral cortex around the mandibular angle-splitting by intraoral approach. The mandible outer cortex was splited with bone chisel and mandible angle was resected by the high-speed pneumatic drill. The bulky masseter muscle and the enbonpoint buecal fat-pad were scissored. Results The application of high-speed pneumatic drill and bone chisel facilitated resection of the mandibular angle with lateral cortex splitting osteetomy. The operative effects were satisfactory in 56 patients during 3-24 months of follow-up. The bigonial distance was effectively re-duced, and facial shape became ellipse. The gross asymmetry and mandibular fracture were not conse-quences. The lateral contour of the mandibular angle was natural. Conclusion Ostectomy of mandible angle and lateral cortex of the mandible allows the reduction of the mandibular contour of the frontal view and the lateral contour of mandibular angle becomes soft, giving a more natural appearance. This new method is worthy to be applied widely because of the good result with effective reduction of the mandibular width.
ABSTRACT
Reduction mandibuloplasty was first operated as an intraoral approach by Converse in 1951. Since then, it bacame the most widely-operated facial contouring surgeries on the patients who has squared appearance with prominent mandibular angle. Lateral cortical ostectomy, two step angle ostectomy and sagittal angle osteotomy are the popular methods of reduction mandibuloplasty. In addition, resection of masseter muscle during surgery and botox injection before or after surgery have been used widely. Recent advancement of the medical appliances and the surgical procedures have slashed the rate of complication such as facial asymmetry, undercorrection, secondary angle formation, surgical hematoma, inferior alveolar nerve injury, subcondylar fracture, transient facial nerve palsy and infection, etc. Acquired facial arteriovenous fistulas except congenital cases rarely develop after stab injuries or panfacial bone fracture or basal skull fracture. Especially, external carotid arteriovenous fistulas have been seldom reported. We experienced a case of external carotid arteriovenous fistula after reduction mandibuloplasty.