ABSTRACT
BACKGROUND: Various surgical options are reported to address the Asian 'squared face', characterized by a prominent mandibular angle (PMA) associated with an oversized chin deformity; but shortcomings lie in the requirement of multi-stage procedures with the risk of further revision surgery. We have developed a single-stage "Mandibular Angle-Body-Chin Curved Ostectomy (MABCCO) and Outer Cortex Grinding (OCG)" surgical technique to shorten the period of the surgical treatment and minimize the inherent surgical risks in the multi-staged procedures. METHODS: A retrospective study involving patients (n = 36) presented with prominent mandibular angle and an oversized chin who underwent the operation described from 2010 to 2012 with at least 12 months of follow-up. The surgical and aesthetic outcomes were evaluated through clinical assessment, photography, imaging analysis including preoperative and post-operative patient satisfaction rates. RESULTS: All the patients were satisfied with the improvement in their appearance following surgery; specifically the 'smoothness' of the mandibular inferior border with no 'second mandibular angle'. The width of the mandible was reduced with G-G distance reduced from 119.9 mm ± 3.9-109.7 mm ± 3.5 (p < 0.05). A significant preoperative and post-operative gonial angle (G-A) was found at the left (110.7° ± 9.6 vs 139.9° ± 11.5, p < 0.05) and right side of mandible (111.3° ± 10.7 vs 140.7° ± 11.8, p < 0.05). There was no iatrogenic inferior alveolar nerve or mental nerve injury and a stable aesthetic outcome beyond the first year. CONCLUSION: We demonstrated favourable surgical and aesthetic outcomes with our single-stage en-bloc curved osteotomy surgical technique to reshape the prominent mandibular angle with a broad chin deformity with no increased in surgical risks but a high satisfaction rate and stable outcomes.
Subject(s)
Chin/abnormalities , Genioplasty/methods , Mandible/abnormalities , Mandibular Osteotomy/methods , Adolescent , Adult , Cephalometry/methods , Chin/pathology , Computer-Aided Design , Esthetics , Female , Follow-Up Studies , Humans , Image Processing, Computer-Assisted/methods , Mandible/pathology , Patient Care Planning , Patient Satisfaction , Photography/methods , Postoperative Complications , Retrospective Studies , Treatment Outcome , User-Computer Interface , Young AdultABSTRACT
BACKGROUND: Fibrous dysplasia (FD) is a tumor-like growth that consists of replacement of the medullary bone with fibrous tissue, causing the expansion and weakening of the areas of bone involved. The most commonly affected bones are facial bones, causing a number of facial cosmetic and functional problems. METHODS: From December 2008 to July 2012, 10 patients with craniomaxillofacial fibrous dysplasia were treated by conservative resection and local recontouring. The patients were followed up yearly, with an average of 3 years; the longest follow-up period was 5 years. RESULTS: All the 10 patients received appropriate treatment and histopathological examinations were performed to confirm the diagnosis of FD. Four patients with zygoma involved had received partial zygoma osteoectomy and 2 patients received mandibular partial osteoectomy. Average time of follow-up was 3 years, with a range from 1 to 5 years, and all patients obtained satisfactory aesthetic and functional results. CONCLUSION: In most patients, a conservative surgery will achieve good functional and aesthetic results. For patients with mild symptoms, the aesthetic effect should be given priority while for the heavier patients the restoration of function and aesthetic effects should all be taken into account.
