颏成形术

Objective: To study the effects of the treatment used high position advancement genioplasty and uvulopalatopharyngoplasty.

目的：观察高位颏前自徙术加悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征的效果。

Othordontics treatments were necessary for all cases except genioplasty before operation.

除单纯颏成形术外，其他所有病例术前均行正畸治疗。

Othordontics treatments were necessary for all cases except genioplasty before operation.

除单纯颏成形术外，其他所有病例术前均行正畸狗屎治疗狗屎。

RESULTS: The distance of maxilla setback was from 4 to 8mm in all eases with Le Fort Ⅰ osteotomy. In the cases with BSSRO, mandible advancement was from 4 to 7mm and chin advancement was from 6 to 8mm in 6 cases with genioplasty.

结果：本组行Le Fort Ⅰ型骨切开上颌骨整体后退4~8mm，14例BSSRO下颌骨前移4~7mm，6例颏成形术颏前移6~8mm.1例一侧腭降动脉术中损伤断裂，经结扎处理，无感染及骨块坏死。16例患者伤口均一期愈合。

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。

Cases underwent bilateral TMJ reconstruction, bone graft and genioplasty in order to advance the jaw. Bimaxillary surgical procedure was completed in 3 cases, and distraction osteogensis and TMJ reconstruction in 6 cases. Al patients gained good appearance, 29 patients can open their mouth larger than 3 cm, and one case had recurrent TMJ ankylosis. 29 cases'AI＜5 and oxygen saturation degree ＞90%(included the patient that had recurrent TMJ ankylosis).

结果 本研究有15例患者接受患侧下颌升支倒置TMJ重建、植骨前移，健侧升支矢状劈开、下颌前移和颏前移成形术；其中有3例行二期的上颌的Le Fort Ⅰ截骨术。6例行双侧TMJ重建、植骨前移下颌和颏成形术。3例施行同期双颌截骨前移和颏成形术；6例行单或双侧TMJ重建、牵引成骨术。

Key words: tempromandibular joint ankylosis; arthroplasty; micrognathia; sagittal split ramus osteotomy; genioplasty

颞颌关节强直；关节成型术；小颌畸形；下颌升支矢状劈开截骨术；颏成形术

Improving and routine intraoral sagittal split ramus osteotomy and advancement genioplasty were the reliable method to patient with micrognathia after arthroplasty of tempromandibular joint ankylosis.

改良下颌升支矢状劈开截骨术和常规下颌升支矢状劈开截骨术及颏水平前徙成形术，是颞颌关节强直关节成型术后小颌畸形可靠的术式。

Under general anesthesia,we cut the bone by sagittal split ramus osteotomy, Lefort-Ⅰ osteotomy, genioplasty, maxillo-mandibule subapical osteotomy, then moved the bone segements to the predictive place in according to the plaster models.

根据临床设计，全麻下分别采用下颌升支矢状劈开截骨术、上颌骨Lefort Ⅰ型截骨术、颏成形术、上下颌骨根尖下截骨术等不同术式，劈开截骨，按设计要求移动骨块，预制钛板进行坚强内固定。

Fancy gold-plated dangling earrings with facetted White Opal crystals.

花式镀金悬垂耳环与facetted白欧泊水晶。

This essay chooses the study aim from biology teachers in middle school in Shi Jiazhuang which tells us that most of the middle school biology teachers in Shi Jiazhuang have the"burnout", lower successfulness, individualize.

本文选取石家庄市初中生物教师作为研究对象，运用问卷调查的方法对石家庄市初中生物教师职业倦怠的现状进行调查，调查结果发现，石家庄市初中生物教师这一群体普遍存在职业倦怠，情感枯竭程度偏高，成就感偏低，去个性化程度最为严重。