摘要目的 探讨一种改良的更加稳定更符合生理功能的颏部截骨整形方法的临床效果.方法 对11例患有颏后缩并伴有长颏畸形的患者采用口内切口卯榫状改良颏部截骨整形术,术中在颏部截骨的近心端及远心端游离骨段形成卯榫结构,通过患者术前术后对比和放射学检查来评估手术效果.结果 所有患者唇龈沟切口均一期愈合,无血肿、无感染、无骨坏死等并发症.术中实测颏前点,平均前移(7.4±1.1) mm;颏部水平去除骨块厚度平均(4.1±1.0) mm,术后X线片显示颏部骨断端固定良好,形态稳定.患者对术后形态改变满意,早期出现不同程度颏部感觉麻木,均于术后2～3个月恢复,无永久性感觉障碍出现.结论 卯榫状颏部截骨整形术能够防止颏部后缩复发,完整保留颏舌肌或颏舌骨肌的附着结构,尽可能地保留了正常解剖生理结构,尤其适用于颏后缩伴有长颏畸形的矫正.

abstractsObjective To explore a new modified stable genioplasty with modified MortiseTenon joints technique and to analyze the surgicaI results in clinic as well as to discuss the advantages in theory.Methods Eleven patients were performed by the genioplasty with Mortise-Tenon joints technique intraoral approach from June 2012 to March 2014,who were suffered from retrusion of chin with different degree accompanying with long chin.The two segments of the chin by osteotomy were made into the Mortise-Tenon joints and fixed by titanium plates.The results were evaluated by clinical appearances and image analyses.Results All 11 patients were satisfied with the procedure and the contour of the chin.The surgical effects were stable without any complications.The advancement in average Mortise-Tenon joints technique was 7.38 mm.Conclusions Much better in stablility and less relapse are achieved by using modified Mortise-Tenon joints technique;furthermore,the genioglossal muscle and geniohyoid muscle are reserved as much as possible,and therefore the normal function of them could be maintained.This method is a good alternative technique for chin retrusion coexisted withlong chin.