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Objective To analyse the morphologic characters of mentum and its use in the treatment of microgenia.

目的 探讨分析小畸形的部形态特征及其在部水平截骨整形手术应用中的效果。

Objective To provide anatomical basis for a new style operation using periosteal flap composed of submental artery, anteroventral portion of digastric muscle and submental artery for the renovation of laryngotrachea.

目的 为应用下动脉二腹肌前腹为蒂的下颌骨骨膜瓣转位修复喉、气管提供解剖学依据。方法对23例(46侧)头颈部标本的下动脉、下静脉、二腹肌前腹的相关结构进行观测。

objective the purpose of this study was to summarize our experience of the application of internal rigid fixation with miniplate to treatment of mandibular fractures.methods a retrospective analyisis of clinical data of 67 cases,who had experienced the anatomic reduction and rigid fixation by using miniplate.with the help of maxillomandibular distraction pre operation and post operation and temporary maxillomandibular fixation during operation,the fracture bones were smoothly reduced and fixed.results clinical and radiographic examination showed that all cases gained good clinical results and precise anatomic alignment of fracture postoperatively without infection,malocclusion,bone malunion or other complications.conclusion mocortical miniplate fixation of the mandible is a reliable and effective techinique providing rigid fixation and an ideal modality for the treatment of mandibular fractures.combined with maxillomandibular fixation.

对67例下颌骨骨折患者的临床资料进行回顾总结,所有患者应用小型接骨板行坚固内固定治疗。其中7例部骨折,12例旁骨折,16例孔区骨折,9例体部多发性骨折,5例体部粉碎性骨折;18例合并其他部位骨折。所有患者术前经临床检查和影像学检查明确骨折的位置和骨折线的数目后,分段牙弓夹板结扎、颌间弹性牵引,使移位的骨折段逐渐复位;术中经口内切开复位、细钢丝颌间结扎、小型接骨板坚固内固定;术后行临床检查和影像学复查,必要时颌间弹性牵引7~10 d。结果所有患者手术切口ⅰ期愈合,治疗效果满意;临床检查所有患者牙合关系良好、面部对称;影像学复查证实骨折线对位良好。结论经口内切开小型接骨板坚固内固定辅以颌间固定治疗下颌骨骨折效果可靠,术后并发症少,是一种理想的手术方法。

Forty adult cadaver heads (male=29,female=11) were dissected to measure genial tubercles and observe the start-stop points of genioglossus muscle and geniohyoid muscle.

选取 4 0具成人尸头,解剖下颌骨、舌肌和舌骨肌,观察舌肌和舌骨肌的起止点和走行,测量棘及其相关参数,然后采用SPSS10 。0统计软件进行分析。

The results are as follows.(1) Long train electrical stimulation at the dMNF facilitated myoelectric activities of genioglossus and phrenic muscle.(2) Short train electrical stimulation of dMNF, when delivered in the inspiratory phase, caused prolongation of myoelectric activities of genioglossus and phrenic muscle; but when delivered in the expiratory phase, myoelectric activities of genioglossus and phrenic muscle were shortened.(3) Long train electrical stimulation at the vMNF inhibited myoelectric activities of genioglossus and phrenic muscle.(4) Short train electrical stimulation of vMNF caused shortening of myoelectric activities of genioglossus and phrenic muscle, when delivered in the inspiratory phase, but a prolongation when delivered in the expiratory phase.(5) The effects of microinjection of glutamate to dMNF and vMNF were similar to those of electrical stimulation.

结果如下:(1)长串电脉冲刺激dMNF引起舌肌和膈肌肌电活动明显增强;(2)短串电脉冲刺激dMNF,当刺激落位于吸气相时,引起舌肌和膈肌在吸气相的肌电活动延长,当刺激落位于呼气相时,引起舌肌和膈肌在呼气相的肌电活动提前终止;(3)长串电脉冲刺激vMNF使舌肌和膈肌肌电活动明显被抑制;(4)短串电脉冲刺激vMNF,当刺激落位于吸气相时,引起舌肌和膈肌在吸气相的肌电活动提前终止,当刺激落位于呼气相时,引起舌肌和膈肌在呼气相的肌电活动延长;(5)在dMNF和vMNF分别微量注射谷氨酸钠,其效应与电刺激结果基本一致。

ConclusionsUsing methods of narrowing genioplasty combined with Medpor implantation can treat wideness chin and retrogenia in one step. This method resolve the defaults of single horizontal osteotomy of the chin or single chin augmentation.

部截骨缩窄结合Medpor隆可一次性矫正部宽大及部后缩畸形,解决了单纯部截骨术后或单纯隆术后局部不能达到最佳的手术效果的弊端。

Methods For gain optimal operation outcome,we used prolong carved mandible angle osteotomy by intraoral approach.we extended osteotomy line to mental nerve.and mental tuber was scoured,Augmentation chin or genioplasty was performed if the patient was subject to microgenia.

为获得更好的术后效果,我们采用口内入路下颌角弧形截骨术,将弧形截骨线延长到神经处,并对结节进行打磨,使截骨线延续流畅,伴小者同时行隆截骨前移。

The changes of gonial angle were effected by the direction of force of chin cap. The gonial angle decreased if the line of force were from chin to condyle. Reversely, the gonial angle would increase because of the more vertical line of force directed from chin to sella.

帽装置对下颚角的影响会因施力方向而不同,如果帽的施力方向为从部到髁头,会使下颚角减少,如果帽装置的施力方向是从部到Sella点,比其他的研究的施力方向还高,反而会使下颚角随著时间增加。

In the soft tissue measurements, the value of soft tissue facial angle and B'-Pos-FH in the first extraction group was less than those in the second extraction group significantly. After treatment all the patients had an increase in S-Ns-Pos angle, soft tissue facial angle, B'-Pos-FH and depth of mentolabial groove. At the same time, soft tissue convexity angle was diminished obviously. But the change was not significant between the two premolar extraction groups.

2在对软组织项目的测量中,治疗前第一前磨牙拔除组的软组织面角、沟倾角均小于第二前磨牙拔除组,治疗后2组均出现软组织面凸角减少,凸角、软组织面角、沟倾角、唇沟深度增加;但2组在各项测量项目的变化上无显著组间差别。

The result manifest that characteristic of chin soft tissue profile of bony malocclusion of class I had bigger angle of chin-lip, shallower mentolabial furrow,smaller radian and larger convexity compared to that of bony malocclusion of class II, and smaller angle of chin-lip, deeper mentolabial furrow,larger radian and smaller convexity compared to that of bony malocclusion of class III.

测量结果显示:骨性II类错牙合部相对于正常牙合发育不足,唇角小,唇沟深,弧度较大,突度较小。而骨性III类错牙合相对于正常牙合部发育过度,唇角大,唇沟浅,弧度较小,突度较大。

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