小下颌

Micrognathia also was more common defects in trisomy 18. The vast majority of fetus with trisomy 13 and 18 can be detected by routine ultrasound examination.

小下颌、叠指畸形也是较常见的畸形，见于18三体。18三体和13三体的畸形在超声筛查中检出率较高。

OBJECTIVE: To study the effects of jaw advancement in treating micromandibular deformity associated with obstructive sleep apnea syndrome by ramus osteotomy and genioplasty.

目的观察下颌升支截骨下颌骨前徙术治疗小下颌畸形伴阻塞性睡眠呼吸暂停综合征的疗效。

METHODS: From April 1998 to February 2002, 12 patients with micromandibular deformity associated with OSAS (aged 14-36 years, 7 females and 5 males) were treated. Invert "L" shape ramus osteotomy and inverted replantation of posterior segment of ramus were performed to reconstruct the TMJ with the jaw advancement and genioplasty at the same time in 7 cases; mandibular angle osteotomy, bone grafts and genioplasty in 3 cases; and the jaw advancement by ramus sagittal osteotomy and genioplasty in 2 cases of the first branchial arch syndrome. RESULTS: The follow-up period was 6 months to 4 years.

1998年4月～2002年2月，对12例(女7例，男5例，年龄14～36岁)伴有严重OSAS症状及张口度0～3.0 cm的小下颌畸形患者，7例采取下颌升支倒&L&形截骨、升支倒置颞下颌关节重建术的同时施行下颌体部前徙和颏成形术；3例在颞下颌关节重建术后进行下颌角部截骨、植骨下颌骨前徙术；2例施行下颌升支矢状劈开、下颌骨前徙术。

The jaw advancement by ramus osteotomy and genioplasty for treating micromandibular deformity associated with OSAS can correct the maxillofacial deformities and enlarge the upper airway space to relieve OSAS. This method has achieved satisfactory result.

结论下颌升支截骨下颌骨前徙术治疗小下颌畸形伴OSAS，对扩张口咽通气道、解除睡眠时呼吸阻塞症状可获得较满意的效果，并同时改善了面部容貌。

Results For the special patients (e.g. patients with mm-chin, high-larynx, fatness, short-neck, fore-tooth standing out, and corpulent lingua), special laryngoscopic lens could stir up epiglottis much more, expose glottis, and achieve incubationeasily. Besides, it could also be applied to normal patients.

结果：保证了一些特殊患者（如小下颌、高喉头、肥胖、舌体肥大、颈短、门齿突出、上颌较高且嘴角突出等）能更好地抬起会厌、显露咽喉腔及声门，保证插管顺利进行，同时也涉足于一般患者的使用。

OBJECTIVE: To assess the value of mandibular distraction osteogenesis in treatment of OSAS in patients with congenital micrognathia and the effect of the surgery on the patients' respiratory functions.

目的：探讨和评价下颌骨牵引成骨技术在治疗小下颌畸形伴OSAS中的应用价值及对呼吸功能的改善作用。

BACKGROUND: Obstructive sleep apnea syndrome in patients with serious micrognathia affects the respiratory function and can be life-threatening.

背景：严重小下颌畸形伴阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome，OSAS)常常危及患者生命，并影响患者的呼吸功能。

Objective: This paper evaluates the effect of distraction osteogenesis in treatment of mandibular micrognathia accompanying with obstructive sleep apnea hypopnea syndrome.

目的：探讨牵引成骨术在治疗小下颌畸形伴阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome， OSAHS)中的应用。

PARTICIPANTS: Eight consecutive patients with congenital micrognathia who developed OSAS were hospitalized from October 2001 to July 2004 at the Center of Craniomaxillofacial Surgery, Plastic Surgery Hospital of Peking Union Medical College and Plastic and Maxillofacial Surgery Unit of Royal Children's Hospital of Melbourne, Australia. This group included 5 male and 3 female patients aged 4 months to 17 years.

对象：2001-10/2004-07在中国医学科学院中国协和医科大学整形外科医院和澳大利亚墨尔本皇家儿童医院颅面外科就治的小下颌畸形伴OSAS患者8例，男5例，女3例，年龄4个月～17岁。

Among them,5 were＜2 years old,6 with craniofacial deformity:small mandible andmandibular retrusion(5 cases),transverse facial cleft(1 case),Down's syndrome(2 cases),cerebral palsy(2 cases),chronic bronchitis(3 cases)and mucopolysaccharidoses(1 case).Nineteen patients with symptoms of snoring, mouth breathing,were diagnosised as OSAHS by polysemnographyand treated by tonsillectomy andadenoidectomy in hospital.All patients were closely followed-up.

全组患儿中年龄＜2岁者5例，伴有颅面部畸形者6例(小下颌、下颌后缩5例，面横裂1例)，Down综合征2例，脑瘫2例，伴有慢性支气管炎者3例，黏多糖病1例。19例患儿均住院行整夜多道睡眠监测并接受扁桃体和腺样体切除手术，并对所有患儿进行随访。

The absorption and distribution of chromium were studied in ryeusing nutrient culture technique and pot experiment.

采用不同浓度K2CrO4(0，0.4，0.8和1.2 mmol/L)的Hoagland营养液处理黑麦幼苗，测定铬在黑麦体内的亚细胞分布、铬化学形态及不同部位的积累。

By analyzing theory foundation of mathematical morphology in the digital image processing, researching morphology arithmetic of the binary Image, discussing two basic forms for the least structure element: dilation and erosion.

通过分析数学形态学在图像中的理论基础，研究二值图像的形态分析算法，探讨最小结构元素的两种基本形态：膨胀和腐蚀；分析了数学形态学复杂算法的基本原理，把数学形态学的部分并行处理理念引入到家实际应用中。