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目的探讨基于骨性受累进行性半侧颜面萎缩的临床分型与治疗策略。方法对2009-2016年收治51例进行性半侧颜面萎缩患者,根据面部骨骼受累的程度,提出不同的分型与治疗策略。Ⅰ型面部骨骼未受累,其治疗策略是面部软组织的形态重塑;Ⅱ型面部骨骼受累,口颌功能未受累,其治疗策略是面部软组织以及骨组织的形态重塑;Ⅲ型面部骨骼及口颌功能均受累,其治疗策略是口颌系统的功能重建以及面部轮廓的形态重塑。结果 51例患者获随访6~36个月,Ⅰ、Ⅱ型患者面部对称性得到明显改善;Ⅲ型患者中,5例获得良好的口颌功能重建以及骨与软组织的形态重塑。结论该分型对于规范与指导进行性半侧颜面萎缩的治疗具有临床意义。
Objective To investigate the clinical classification and treatment strategy of progressive hemivertebra facial atrophy based on skeletal involvement. Methods Fifty-one patients with progressive facial hemifacial atrophy in 2009-2016 were enrolled. According to the extent of facial bone involvement, different classification and treatment strategies were proposed. Type I facial bones are not involved. The treatment strategy is the remodeling of facial soft tissue. Type II facial bones are involved and their oral or maxillary functions are not involved. The treatment strategy is the remodeling of facial soft tissue and bone tissue. The type Ⅲ facial bones and mouth Mandibular function is involved, and its therapeutic strategy is the functional reconstruction of the oral jaw system and the morphological remodeling of facial contours. Results Fifty-one patients were followed up for 6 to 36 months. The facial symmetry of type Ⅰ and type Ⅱ patients was significantly improved. Among type Ⅲ patients, 5 patients received good reconstruction of oral maxillary function and remodeling of bone and soft tissue. Conclusions This classification is of clinical significance for regulating and guiding the treatment of progressive hemifacial atrophy.