假体隆颏联合颏肌放松治疗轻中度小颏畸形疗效观察(1)
[摘要]目的：观察假体隆颏联合颏肌放松治疗轻中度小颏畸形的临床效果。方法：收集2015年2月-2017年12月小颏畸形伴颏肌紧张患者46例(其中轻度31例，中度15例)，均采用硅胶假体隆颏联合A型肉毒毒素注射颏肌治疗。采用双盲法，治疗前后由两位美容科医生独立采集数据：①测量就医者颏前点到Richett's 审美平面的距离；②测定颏点是否处于鼻根点和鼻下点与眶耳平面的垂线之间；③测定治疗前后的面高比。所得统计指标采用SPSS 19.0统计软件分析。结果：术后随访3～12个月，失访5例。38例患者对术后颏部形态满意，发生假体移位2例，感染1例，下唇麻木2例，40d内感觉恢复，其余患者无不适，切口均一期愈合，无1例假体外露。经统计学分析，患者治疗前(6.15±2.319)mm和治疗后(0.89±0.737)mm测量指标存在统计学差异(t=16.106，P<0.01)。结论：假体隆颏结合A型肉毒毒素注射颏肌治疗轻、中度小颏畸形伴颏肌紧张，与单一的隆颏手术方式比较，减少了隆颏术后的并发症，使面部轮廓更加自然，值得临床推广应用。
[关键词]小颏畸形；颏肌紧张；隆颏术；硅胶假体；肉毒毒素
, http://www.100md.com
[中图分类号]R783 [文献标志码]A [文章编号]1008-6455(2018)07-0112-04
Abstract： Objective To observe the effect of chin augmentation combined with mentalis relaxation in treatment of mild to moderate chin microsomia. Methods From February 2015 to December 2017， 46 patients with mild to moderate chin microsomia and mentalis tension underwent treatment of silicone prosthesis augmentation with botulinum toxin A injection.Adopting a double-blind method，before and after treatment， two cosmetology doctors independently collected data which were comprised of measuring the distance between the pogonion and the Richett's aesthetic plane，and determining whether the chin point was between the range of the two lines which were perpendicular to the orbitomeatal plane and passed through the the nasion and the subnasal point separately，and measuring the surface height ratio.The statistical indicators were analyzed by SPSS 19 statistical software. Results To follow-up 3to 12 months after the operation， and 5 people were lost.38 cases were satisfied with the effect of treatment， 2 cases of prosthesis displacement， one case of infection， 2 cases of numbness of lower lip after operation， and recovery within 40 days.The rest of the patients were unsuitable，the incision healed at the first stage， and no prosthesis was exposed. Conclusion Chin augmentation combined with botulinum toxin A injection， which reduces the postoperative complications and makes the facial contour more natural，is more effective than single prosthesis augmentation surgery，and it is worthy of popularization and application.
, 百拇医药
Key words： chin microsomia； mentalis tension； chin augmentation； silicone implant； botulinum toxin A
小頦畸形系因遗传或内分泌障碍、炎症、外伤等因素造成颏联合处发育畸形，常常伴随着不同程度的颏肌紧张，是造成下颌后缩的常见原因[1]。单纯的假体隆颏术往往只解决了下颌后缩的表面问题，而颏肌紧张未得到解决。颏肌紧张不仅会上提颏部皮肤，使皮肤变得凹凸不平，严重影响术后颏部外观；还会增加术后假体移位、颏部骨质吸收的发生率[2]。为了提高隆颏术后效果，减少术后并发症，笔者采用硅胶假体隆颏联合A型肉毒毒素注射颏肌治疗小颏畸形患者，在临床应用中取得了较好疗效，现将结果报道如下。
1 资料和方法
1.1 一般资料：收集2015年2月-2017年12月在米兰柏羽医学美容医院行硅胶假体隆颏联合A型肉毒毒素注射颏肌治疗轻中度小颏畸形患者46例，单纯颏部发育不足伴颏肌紧张，上下颌骨咬合关系正常，均为女性，年龄20～38岁。①采用鼻尖点与上唇前点的连线来确定 Richett's 审美平面(见图1A，1B)，根据颏前点在Richett's平面上的后缩程度将小颏畸形分为轻、中、重度[3]。本次纳入小颏畸形轻度31例[颏部后缩4～6mm，平均(4.68±0.702)mm]，中度15例[颏部后缩8～11mm，平均(9.20±1.207)mm]；②通过软组织的鼻根点和鼻下点两点作两条与眶耳平面垂直的线，正常人颏点应在两条垂线之间，超出此范围则被视为巨颏或小颏(见图1C)[4]；③协调的面容可用黄金分割法经发际、眉间、鼻小柱基底及颏下缘的水平线，将面高三等分(见图1D)。, 百拇医药(薛美思 张强 梁发贵)
[关键词]小颏畸形；颏肌紧张；隆颏术；硅胶假体；肉毒毒素
, http://www.100md.com
[中图分类号]R783 [文献标志码]A [文章编号]1008-6455(2018)07-0112-04
Abstract： Objective To observe the effect of chin augmentation combined with mentalis relaxation in treatment of mild to moderate chin microsomia. Methods From February 2015 to December 2017， 46 patients with mild to moderate chin microsomia and mentalis tension underwent treatment of silicone prosthesis augmentation with botulinum toxin A injection.Adopting a double-blind method，before and after treatment， two cosmetology doctors independently collected data which were comprised of measuring the distance between the pogonion and the Richett's aesthetic plane，and determining whether the chin point was between the range of the two lines which were perpendicular to the orbitomeatal plane and passed through the the nasion and the subnasal point separately，and measuring the surface height ratio.The statistical indicators were analyzed by SPSS 19 statistical software. Results To follow-up 3to 12 months after the operation， and 5 people were lost.38 cases were satisfied with the effect of treatment， 2 cases of prosthesis displacement， one case of infection， 2 cases of numbness of lower lip after operation， and recovery within 40 days.The rest of the patients were unsuitable，the incision healed at the first stage， and no prosthesis was exposed. Conclusion Chin augmentation combined with botulinum toxin A injection， which reduces the postoperative complications and makes the facial contour more natural，is more effective than single prosthesis augmentation surgery，and it is worthy of popularization and application.
, 百拇医药
Key words： chin microsomia； mentalis tension； chin augmentation； silicone implant； botulinum toxin A
小頦畸形系因遗传或内分泌障碍、炎症、外伤等因素造成颏联合处发育畸形，常常伴随着不同程度的颏肌紧张，是造成下颌后缩的常见原因[1]。单纯的假体隆颏术往往只解决了下颌后缩的表面问题，而颏肌紧张未得到解决。颏肌紧张不仅会上提颏部皮肤，使皮肤变得凹凸不平，严重影响术后颏部外观；还会增加术后假体移位、颏部骨质吸收的发生率[2]。为了提高隆颏术后效果，减少术后并发症，笔者采用硅胶假体隆颏联合A型肉毒毒素注射颏肌治疗小颏畸形患者，在临床应用中取得了较好疗效，现将结果报道如下。
1 资料和方法
1.1 一般资料：收集2015年2月-2017年12月在米兰柏羽医学美容医院行硅胶假体隆颏联合A型肉毒毒素注射颏肌治疗轻中度小颏畸形患者46例，单纯颏部发育不足伴颏肌紧张，上下颌骨咬合关系正常，均为女性，年龄20～38岁。①采用鼻尖点与上唇前点的连线来确定 Richett's 审美平面(见图1A，1B)，根据颏前点在Richett's平面上的后缩程度将小颏畸形分为轻、中、重度[3]。本次纳入小颏畸形轻度31例[颏部后缩4～6mm，平均(4.68±0.702)mm]，中度15例[颏部后缩8～11mm，平均(9.20±1.207)mm]；②通过软组织的鼻根点和鼻下点两点作两条与眶耳平面垂直的线，正常人颏点应在两条垂线之间，超出此范围则被视为巨颏或小颏(见图1C)[4]；③协调的面容可用黄金分割法经发际、眉间、鼻小柱基底及颏下缘的水平线，将面高三等分(见图1D)。, 百拇医药(薛美思 张强 梁发贵)