摘要/Abstract
摘要： 目的·使用面部软组织三维测量方法分析中国颌骨畸形患者行上颌骨Le Fort Ⅰ型截骨前移后鼻唇部软组织的变化规律。方法·选择2017年1—12月于上海交通大学医学院附属第九人民医院口腔颅颌面科接受上颌骨Le Fort Ⅰ型截骨术前移下降及双侧下颌支矢状劈开术截骨后退（双颌手术）治疗的37例骨性Ⅲ类错畸形患者为研究对象。患者于术前1周内及术后6个月行全头颅螺旋CT扫描和面部软组织三维立体摄像。使用3dMD vultus软件对鼻唇部软组织的测量标志点及相关距离、角度进行标记及测量，并比较手术前后的差异。结果·双颌手术后患者鼻翼宽度平均增加0.82 mm，鼻翼基底宽度平均增加1.07 mm，上唇长度平均增加1.41 mm，鼻唇角平均增加3.09?，鼻尖角平均减小1.51?，且差异具有统计学意义（均P<0.05），而鼻高度、鼻背长度、鼻额角基本稳定。结论·经上颌骨Le FortⅠ型截骨前移后，颌骨畸形患者的面部有所改善，同时其鼻唇部软组织也有一定改变。
关键词: 正颌手术, 鼻唇部软组织变化, 三维测量分析
Abstract:
Objective · To evaluate nasolabial soft tissue changes of Chinese patients with malocclusion after maxillary anterior movement by Le FortⅠosteotomy with three-dimensional measurement. Methods · From Jan. to Dec. 2017, 37 patients with skeletal Class Ⅲ malocclusion from Department of Oral and Craniomaxillofacial Surgery of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, who underwent maxillary Le FortⅠosteotomy for anterior movement and bilateral sagittal split ramus osteotomy (bi-maxillary orthognathic surgery), were included. A full cranial spiral CT scan and three-dimensional facial soft tissue images were performed within 1 week before and 6 months after operation. Landmarks, relative distance and angle of nasolabial soft tissue were located and measured by 3dMD vultus software, and the differences before and after operation were compared. Results · After bi-maxillary orthognathic surgery, the alar width increased by an average of 0.82 mm, the subalar width increased by an average of 1.07 mm, the upper lip length increased by an average of 1.41 mm, the nasolabial angle increased by an average of 3.09?, and the pronasal angle decreased by an average of 1.51?(all P<0.05), while nasal height, nasal length and nasal frontal angle were basically stable. Conclusion · After the maxillary Le Fort I osteotomy for anterior movement, the face of patient with malocclusion is improved, and the nasolabial soft tissue is also changed.
Key words: orthognathic surgery, nasolabial soft tissue change, three-dimensional measurement and analysis
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