Journal of Cranio-Maxillofacial Surgery最新文献

Effectiveness of oral posaconazole and surgical debridement of rhino maxillofacial mucormycosis. 口服泊沙康唑和手术清创治疗犀牛颌面粘液瘤病的效果。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-04 DOI: 10.1016/j.jcms.2024.10.010

Satnam Singh Jolly, Vidya Rattan, Apoorva Singh

引用次数: 0

A generalizable procedure for Brown's class Ⅱ and Ⅲ defects reconstruction with deep circumflex iliac artery flap using computer-assisted technique. 使用计算机辅助技术重建髂深周动脉皮瓣的布朗Ⅱ级和Ⅲ级缺损的通用程序。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-02 DOI: 10.1016/j.jcms.2024.10.009

Chun-Bo Dou, Xiao-Pei Gao, Zi-Li Yu, Jun Jia

Objective: This study summarizes and analyzes the characteristics of deep circumflex iliac artery (DCIA) flap reconstruction for maxillary defects and proposes a generalized protocol under the guidance of computer-assisted technique to enhance surgical efficiency and success rate.

Materials and methods: We retrospectively reviewed 10 cases of maxillary defects reconstructed using DCIA flaps under the application of computer-assisted technique, collecting clinical data for statistical analysis.

Results: These cases included 2 cystic lesions, 2 mucinous tumors, 2 ameloblastomas, 1 mucoepidermoid carcinoma, 1 odontogenic fibroma, 1 bone defect following squamous cell carcinoma (SCC) surgery, and 1 ossifying fibroma. According to Brown's classification system, there were 7 Type IIb defects, 1 Type IId defect, 1 Type IIIb defect, and 1 Type IIId defect. The length of the iliac bone harvested ranged from 42 mm to 100 mm, and the width from 20 mm to 51 mm. In 7 patients, chimeric iliac myofascial flaps were used; in 2 patients, deep circumflex iliac artery perforator (DCIAP) flaps were utilized; and in 1 patient, a vascularized iliac crest was employed. The recipient vessels were the facial artery and vein in all cases. Intraoral anastomoses were performed in 4 cases, and submandibular anastomoses in 6 cases. The donor site was chosen from the ipsilateral ilium in 8 patients and from the contralateral ilium in 2 patients. The mean operative time was 8.74 hours. Postoperatively, 9 patients recovered well without any complications, while 1 patient experienced necrosis of the bone flap on the first day after surgery and underwent secondary reconstruction using a vascularized fibula flap. The average postoperative hospital stay was 8.6 days.

Conclusion: The combination of DCIA flaps with computer-assisted technique provides a reliable method for the reconstruction of maxillary defects and functional restoration. Establishing generalized procedures could facilitate its broader application.

目的：本研究总结分析了髂周深动脉（DCIA）皮瓣重建上颌骨缺损的特点，并提出了在计算机辅助技术指导下提高手术效率和成功率的通用方案：回顾性分析了10例在计算机辅助技术应用下使用DCIA皮瓣重建的上颌骨缺损病例，收集临床数据进行统计分析：这些病例包括2例囊性病变、2例黏液瘤、2例釉母细胞瘤、1例黏液表皮样癌、1例牙源性纤维瘤、1例鳞状细胞癌（SCC）术后骨缺损和1例骨化性纤维瘤。根据布朗分类系统，共有 7 例 IIb 型缺损、1 例 IId 型缺损、1 例 IIIb 型缺损和 1 例 IIId 型缺损。采集的髂骨长度从 42 毫米到 100 毫米不等，宽度从 20 毫米到 51 毫米不等。7名患者使用了嵌合髂肌筋膜瓣；2名患者使用了髂周深动脉穿孔器（DCIAP）瓣；1名患者使用了血管化髂嵴。所有病例的受体血管均为面部动脉和静脉。4例进行了口内吻合，6例进行了颌下吻合。8 例患者的供体部位选自同侧髂骨，2 例患者的供体部位选自对侧髂骨。平均手术时间为 8.74 小时。术后，9 名患者恢复良好，未出现任何并发症，1 名患者在术后第一天出现骨瓣坏死，需要使用血管化腓骨瓣进行二次重建。术后平均住院时间为 8.6 天：结论：DCIA 骨瓣与计算机辅助技术的结合为上颌骨缺损的重建和功能恢复提供了一种可靠的方法。建立通用程序可促进其更广泛的应用。

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引用次数: 0

PSI: Planner-specific, physician-specific, or patient-specific implant for orbital reconstruction? PSI：用于眼眶重建的植入物是针对规划师、医生还是患者？

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.03.004

J.F. Sabelis , E. Shaheen , R. Willaert , A.G. Becking , L. Dubois , R. Schreurs

This study aimed to identify and quantify the variations in PSI designs intended for an identical patient.

Records from 10 patients with an orbital fracture involving two walls, for which a primary orbital reconstruction was indicated, were retrospectively included. Clinical engineers from two centers independently generated proposal designs for all patients. Following web meeting(s) with the surgeon from the same institute, the PSI designs were finalized by the engineer. A cross-over of the engineer with the surgeon of the other center created two new design teams. In total, 20 proposal and 40 final PSI designs were produced. A three-dimensional comparison between different PSI designs for the same patient was performed by computing a difference score.

Initially, the design proposals of the two engineers showed a median difference score of 37%, which was significantly reduced to a median difference score of 26% for the final designs with different engineers. The median difference score of 22% between surgeons demonstrated that both parties introduced notable user variations to the final designs. Evidence supporting the advantages of an experienced design team was found, with significantly fewer modifications, fewer meetings, and less time required to complete the design (up to 40% time reduction).

The findings of the study underline the dependency of PSI design on the surgeon and engineer, and support the need for a more evidence-based protocol for PSI design.

本研究旨在识别和量化针对相同患者的 PSI 设计差异。研究回顾性地纳入了 10 名眼眶骨折患者的记录，这些患者的眼眶骨折涉及两面壁，需要进行眼眶重建。来自两个中心的临床工程师为所有患者独立生成了方案设计。在与来自同一机构的外科医生进行网络会议后，由工程师最终确定 PSI 设计方案。工程师与另一个中心的外科医生交叉组建了两个新的设计团队。总共产生了 20 份 PSI 设计提案和 40 份最终设计方案。通过计算差异分值，对同一患者的不同 PSI 设计进行了三维比较。最初，两名工程师的设计方案差异中位数为 37%，而在不同工程师的最终设计方案中，差异中位数大幅减少至 26%。外科医生之间的差异中位数为 22%，这表明双方在最终设计中都引入了明显的用户差异。有证据表明，经验丰富的设计团队更有优势，修改次数明显减少，会议次数明显减少，完成设计所需时间明显减少（最多减少 40%）。研究结果强调了 PSI 设计对外科医生和工程师的依赖性，并支持有必要为 PSI 设计制定更加循证的协议。

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引用次数: 0

3-Dimensional accuracy of navigation-guided bimaxillary orthognathic surgery: A systematic review and meta-analysis 导航引导的双颌正颌手术的三维准确性：系统回顾和荟萃分析。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.08.010

Leonardo Saigo , Felix Schrader , Majeed Rana , Max Wilkat

The transfer of a virtual orthognathic surgical plan to the patient still relies on the use of occlusal splints, which have limitations for vertical positioning of the maxilla. The use of real-time navigation has been proposed to enhance surgical accuracy. This systematic review (PROSPERO CRD42024497588) aimed to investigate if surgical navigation can improve the three-dimensional accuracy of orthognathic surgery. The inclusion criteria were orthognathic surgery, use of intra-operative navigation and quantitative assessment of surgical accuracy. The exclusion criteria were non-bimaxillary orthognathic surgeries, non-clinical studies, studies without post-operative 3D analysis and publications not in the English language. A search of PubMed, Embase and Cochrane Library generated 940 records, of which 12 were found relevant. Risk of bias was assessed done using the Joanna Briggs Institute Critical Appraisal Checklist Tool. Among the included studies, there were nine of observational character and three randomized control studies (RCTs). All studies demonstrated promising outcomes with reported good surgical accuracy within a 2 mm difference between the planned and post-surgical result. Meta-analysis of two RCTs was carried out and results were in favor of surgical navigation with a total odds ratio of 4.44 [2.11, 9.37] and an overall effect outcome of Z = 3.92 (p < 0.0001). Navigation was up to 0.60 mm more accurate than occlusal wafers only (p < 0.001). However, there were variations in the application of surgical navigation and methods of analysis, leading to a heterogenous data set. Future studies should focus on standardized protocols and analysis methods to further validate the use of surgical navigation in orthognathic surgery. Despite some limitations, surgical navigation shows potential as a valuable tool in improving the accuracy of orthognathic surgery.

将虚拟正颌手术计划传输给患者仍然依赖于咬合夹板的使用，而咬合夹板在上颌骨垂直定位方面存在局限性。有人建议使用实时导航来提高手术的准确性。本系统性综述（PROSPERO CRD42024497588）旨在研究手术导航是否能提高正颌外科手术的三维精确度。纳入标准为正颌外科手术、术中导航的使用和手术准确性的定量评估。排除标准为非双颌正颌手术、非临床研究、无术后三维分析的研究以及非英语出版物。通过对 PubMed、Embase 和 Cochrane 图书馆的检索，共获得 940 条记录，其中 12 条为相关记录。采用乔安娜-布里格斯研究所的 "批判性评估清单工具 "对偏倚风险进行了评估。在纳入的研究中，有 9 项观察性研究和 3 项随机对照研究（RCT）。所有研究都显示了良好的结果，手术准确性良好，计划结果与手术后结果相差不超过 2 毫米。对两项随机对照研究进行了元分析，结果表明手术导航的总几率为 4.44 [2.11, 9.37]，总效应结果为 Z = 3.92（P＜0.05）。

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引用次数: 0

Metastatic malignancies in the parotid gland: A retrospective study 腮腺转移性恶性肿瘤：一项回顾性研究。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.08.007

Michał Gontarz , Marta Urbańska , Jakub Bargiel , Krzysztof Gąsiorowski , Tomasz Marecik , Paweł Szczurowski , Jan Zapała , Grażyna Wyszyńska-Pawelec

The aim of this study was to compare treatment modalities, pathological and clinical characteristics, and outcomes in patients with metastasis in a parotid gland.

The medical records of 34 patients who received treatment for metastasis in the parotid gland over a twenty-year period were evaluated. Patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) metastasis were retrospectively reclassified using the P/N and N1S3 staging system.

Patients with neck metastasis showed a significantly poorer prognosis (P = 0.025). Univariate analysis also revealed that extent of parotidectomy and type of neck dissection did not influence recurrence free survival (RFS) and overall survival (OS). When comparing the usefulness of the P/N and S1N3 staging systems, a positive correlation was observed between the P stage and the N1S3 stage in both RFS and OS.

The extent of parotidectomy and concomitant neck dissection is still under discussion. Total parotidectomy and modified radical neck dissection did not improve RFS and OS. N1S3 is a less complex classification and possesses a higher predictive value when compared to the P/N staging system.

本研究的目的是比较腮腺转移患者的治疗方式、病理和临床特征以及疗效。研究评估了 34 名腮腺转移患者在 20 年间接受治疗的病历。采用P/N和N1S3分期系统对头颈部皮肤鳞状细胞癌（HNcSCC）转移患者进行了回顾性重新分类。颈部转移的患者预后明显较差（P = 0.025）。单变量分析还显示，腮腺切除范围和颈部切除类型并不影响无复发生存率（RFS）和总生存率（OS）。在比较P/N和S1N3分期系统的实用性时，P分期和N1S3分期在RFS和OS中均呈正相关。腮腺切除术和同时进行的颈部切除术的范围仍在讨论中。腮腺全切除术和改良根治性颈部切除术并不能改善RFS和OS。与P/N分期系统相比，N1S3是一种不那么复杂的分类，具有更高的预测价值。

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引用次数: 0

EACMFS Prizes & Awards EACMFS 奖项

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/S1010-5182(24)00296-8

引用次数: 0

Clinical analysis of Le Fort III distraction for obstructive sleep apnea in pediatric patients with syndromic craniosynostosis Le Fort III牵引治疗综合颅畸形儿科患者阻塞性睡眠呼吸暂停的临床分析

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.04.002

Purpose

This study aimed to analyze correlations among respiratory function, upper airway expansion, and the extent of midface advancement in syndromic craniosynostosis patients with obstructive sleep apnea.

Materials and methods

A retrospective study was conducted in 21 children with syndromic craniosynostosis who underwent Le Fort III osteotomy and distractive osteogenesis at the Department of Oral and Maxillofacial Surgery of Peking University International Hospital from October 2017 to December 2022. Computed tomography (CT) data of patients before surgery (T0), 3 months after surgery (T1), and 1 year after surgery (T2) were reviewed. Sleep apnea was evaluated using polysomnography at the corresponding postoperative times. Skeletal changes were evaluated by cephalometric measurements; airway morphology was evaluated by two-dimensional cross square and three-dimensional volume; and respiratory function was measured using the apnea-hypopnea index (AHI), mean oxygen saturation (SpO₂), minimum SpO₂, and the 3% decline in the SpO₂ index. A paired t-test was used to evaluate changes before and after surgery. A P value of <0.05 was considered to indicate statistical significance. Pearson correlation analysis was used to determine correlations among the skeletal structure, airway morphology, and respiratory function.

Results

Significant differences were noted between T0 and T1 in terms of cephalometry landmarks, airway volume, and cross-sectional area (P < 0.05) but not between T1 and T2 (P > 0.05). Similarly, significant differences were detected in AHI, average SpO₂ level, minimum SpO₂ level, and 3% oxygen hypoxia index between T0 and T1 but not between T1 and T2 (P > 0.05). The change in SN-PNS was significantly correlated with an improvement in AHI (P = 0.024) and 3% oxygen hypoxia index (P = 0.019), and the change in palatopharyngeal airway area(Ar B) was significantly correlated with an improvement in minimum SpO₂ (P = 0.018).

Conclusion

Le Fort III osteotomy and distraction are effective in enlarging the upper airway width and improving sleep apnea in syndromic craniosynostosis patients. Cephalometric changes in S-PNS and improvement in Ar B were correlated with long-term improvements in polysomnography outcomes.

材料与方法对2017年10月至2022年12月在北京大学国际医院口腔颌面外科接受Le Fort III截骨术和牵张成骨术的21例综合征颅脑发育不良患儿进行回顾性研究。回顾了患者术前（T0）、术后3个月（T1）和术后1年（T2）的计算机断层扫描（CT）数据。在相应的术后时间，使用多导睡眠监测仪对睡眠呼吸暂停进行评估。骨骼变化通过头颅测量进行评估；气道形态通过二维交叉方形和三维容积进行评估；呼吸功能通过呼吸暂停-低通气指数（AHI）、平均血氧饱和度（SpO2）、最低SpO2和SpO2指数下降3%进行测量。采用配对 t 检验来评估手术前后的变化。P 值为 0.05 时表示统计学意义显著。结果T0和T1之间在头颅测量地标、气道容积和横截面积方面存在显著差异（P <0.05），但T1和T2之间没有显著差异（P >0.05）。同样，AHI、平均 SpO2 水平、最低 SpO2 水平和 3% 缺氧指数在 T0 和 T1 之间存在显著差异，但在 T1 和 T2 之间无显著差异（P >；0.05）。SN-PNS的变化与AHI（P = 0.024）和3%缺氧指数（P = 0.019）的改善显著相关，腭咽气道面积（Ar B）的变化与最小SpO2的改善显著相关（P = 0.018）。S-PNS的头型测量变化和Ar B的改善与多导睡眠监测结果的长期改善相关。

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引用次数: 0

Perioperative care in orthognathic surgery - A systematic review and meta-analysis for enhanced recovery after surgery 正颌外科手术的围手术期护理 - 促进术后恢复的系统回顾和荟萃分析。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.08.014

Anne-Kathrin Bär , Richard Werkmeister , Joseph C. Dort , Bilal Al-Nawas

The aim of this study was to determine whether implementing ERAS (Enhanced Recovery After Surgery) elements/protocols improves outcomes in orthognathic surgery (OGS) compared to conventional care. To achieve this, ERAS-specific perioperative elements were identified and literature on ERAS for OGS was systematically reviewed. Using PRISMA methodology and GRADE approach, 44 studies with 49 perioperative care elements (13 pre-, 15 intra-, 21 postoperative) were analyzed. While 39 studies focused on single elements, only five presented multimodal protocols, with three related to ERAS. Preoperative elements included antimicrobial and steroid prophylaxis and prevention of postoperative nausea and vomiting. Intraoperative aspects, especially anesthesiological, showed high evidence. Outcome parameters were heterogeneous: complications and postoperative pain were well-investigated with high evidence, while length of stay (LOS) and patient satisfaction received low to medium evidence. ICU LOS, healthcare costs, and readmission rates were underreported. The meta-analysis revealed significant results for pain reduction and trends towards fewer complications and shorter LOS in the ERAS group. Overall, ERAS protocols are not established in OMFS, particularly OGS. Further research is needed in pre- and postoperative care and standardized multimodal analgesia. The next step should be developing a comprehensive OGS protocol through a consensus conference and implementing it in clinical practice.

本研究的目的是确定与传统护理相比，实施 ERAS（术后强化恢复）要素/方案是否能改善正颌外科手术（OGS）的疗效。为此，我们确定了ERAS特定的围手术期要素，并系统地回顾了有关ERAS用于OGS的文献。采用PRISMA方法和GRADE方法，对44项研究的49个围术期护理要素（13个术前、15个术中、21个术后）进行了分析。有 39 项研究侧重于单一要素，只有 5 项研究提出了多模式方案，其中 3 项与 ERAS 有关。术前要素包括抗菌素和类固醇预防以及术后恶心和呕吐的预防。术中方面，尤其是麻醉方面的证据较多。结果参数不尽相同：并发症和术后疼痛的研究证据较多，而住院时间（LOS）和患者满意度的研究证据为中低水平。对重症监护室的住院时间、医疗费用和再入院率的报告不足。荟萃分析显示，ERAS组在减轻疼痛方面有显著效果，并有减少并发症和缩短住院时间的趋势。总体而言，ERAS 方案尚未在 OMFS（尤其是 OGS）中确立。在术前、术后护理和标准化多模式镇痛方面还需要进一步研究。下一步应该通过共识会议制定全面的 OGS 方案，并在临床实践中实施。

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引用次数: 0

In vivo endocultivation of CAD/CAM hybrid scaffolds in the omentum majus in miniature pigs 在微型猪的大网膜中对 CAD/CAM 混合支架进行体内内培养。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.04.012

Juliane Wagner , Lennart Bayer , Klaas Loger , Yahya Acil , Sascha Kurz , Johannes Spille , Matthias Ahlhelm , Lena-Christin Ingwersen , Anika Jonitz-Heincke , Sam Sedaghat , Jörg Wiltfang , Hendrik Naujokat

Purpose

Correction of bony mandibular defects is a challenge in oral and maxillofacial surgery due to aesthetic and functional requirements. This study investigated the potential of a novel hybrid scaffold for bone regeneration and degradation assessment of the ceramic within the omentum majus over 6 months and the extent to which rhBMP-2 as a growth factor, alone or combined with a hydrogel, affects regeneration.

Materials and methods

In this animal study, 10 Göttingen minipigs each had one scaffold implanted in the greater omentum. Five animals had scaffolds loaded with a collagen hydrogel and rhBMP-2, and the other five animals (control group) had scaffolds loaded with rhBMP-2 only. Fluorochrome injections and computed tomography (CT) were performed regularly. After 6 months, the animals were euthanized, and samples were collected for microCT and histological evaluations.

Results

Fluorescent and light microscopic and a CT morphological density evaluation showed continuous bone growth until week 16 in both groups. Regarding the ratio of bone attachment to the Zr02 support struts, the rhBMP-2 loaded collagen hydrogel group showed with 63% a significantly higher attachment (p > 0.001) than the rhBMP-2 control group (49%).

Conclusion

In this study, bone growth was induced in all omentum majus specimens until post-operative week 16. Furthermore, hydrogel and rhBMP-2 together resulted in better bone-scaffold integration than rhBMP-2 alone. Further studies should investigate whether implantation of the scaffolds in the jaw after an appropriate period of bone regeneration leads to a stable situation and the desired results.

目的：由于美学和功能要求，下颌骨缺损的矫正是口腔颌面外科的一项挑战。本研究调查了一种新型混合支架在骨再生方面的潜力，并对大网膜内陶瓷在 6 个月内的降解情况进行了评估，以及作为生长因子的 rhBMP-2 单独或与水凝胶结合对再生的影响程度：在这项动物研究中，10 只哥廷根小型猪的大网膜各植入了一个支架。其中五只动物的支架装有胶原水凝胶和 rhBMP-2，另外五只动物（对照组）的支架只装有 rhBMP-2。定期进行荧光注射和计算机断层扫描（CT）。6 个月后，动物安乐死，收集样本进行显微 CT 和组织学评估：结果：荧光显微镜、光学显微镜和计算机断层扫描形态密度评估显示，两组动物的骨生长持续到第16周。结果：荧光显微镜和 CT 形态密度评估显示，两组患者的骨生长持续到第 16 周。就骨附着在 Zr02 支撑杆上的比例而言，rhBMP-2 负载胶原水凝胶组（63%）明显高于 rhBMP-2 对照组（49%）（p > 0.001）：在这项研究中，所有大网膜标本在术后第 16 周前都能诱导骨生长。此外，与单独使用 rhBMP-2 相比，水凝胶和 rhBMP-2 能更好地实现骨与支架的整合。进一步的研究应探讨在适当的骨再生期后将支架植入下颌是否会带来稳定的情况和预期的效果。

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引用次数: 0

Outcome of isolated and combined direct feminization laryngochondroplasty: Our first 20 cases 孤立和联合直接女性化喉软骨成形术的效果：我们的前 20 个病例

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2024-11-01 DOI: 10.1016/j.jcms.2024.03.022

Yael Oestriecher-Kedem , Narin Nard Carmel Neiderman , Guy Levenberg , Yotam Lior , Anat Kidron , Clariel Ianculovici , Shlomi Kleinman , Shimrit Arbel

This retrospective study describes the surgical outcomes of our first 20 transgender women to undergo feminization thyroid laryngochondroplasty (FLC) by a direct transvestibular FLC (DTV-FLC) approach from December 2019 to October 2023. The medical records of all patients were retrieved and reviewed. Data on the operative, postoperative, and follow-up courses, complications, and functional and cosmetic outcomes were retrieved. The cosmetic results were evaluated by four independent facial plastic surgeons. Thirteen patients underwent DTV-FLC combined with genioplasty or genioplasty with mandibular angle reduction and seven underwent isolated DTV-FLC. DTV-FLC was feasible in all planned cases. Complications (skin flap perforation, thyroid cartilage fracture, mental hypoesthesia, hematoma, dehiscence of the vestibular incision, vestibular scar adhesions, and anemia) were minor and resolved spontaneously. The preoperative grade of thyroid cartilage protrusion was 1.9 ± 0.9 on a scale from 1 to 3. The postoperative cosmetic results of 18 patients were judged as having improved (a score of 2.1 ± 0.8 on a scale from −1 to 3). Eighteen patients were satisfied with the cosmetic result, one was dissatisfied (the revision surgery patient), and one was lost to follow-up. In conclusion, DTV-FTLC is a valid surgical approach for FLC, yielding high patient satisfaction and good cosmetic results.

这项回顾性研究描述了 2019 年 12 月至 2023 年 10 月期间，我院首批 20 名跨性别女性通过直接经前庭喉软骨成形术（DTV-FLC）接受女性化甲状腺喉软骨成形术（FLC）的手术结果。对所有患者的病历进行了检索和审查。检索了有关手术、术后和随访过程、并发症以及功能和美容效果的数据。美容效果由四位独立的面部整形外科医生进行评估。13名患者接受了DTV-FLC联合下颌角整形术或下颌角缩小术，7名患者接受了单独的DTV-FLC。在所有计划病例中，DTV-FLC都是可行的。并发症（皮瓣穿孔、甲状软骨骨折、精神感觉减退、血肿、前庭切口裂开、前庭瘢痕粘连和贫血）都很轻微，并能自行缓解。术前甲状软骨突出的等级为（1.9 ± 0.9），评分标准为 1-3 分。18 名患者的术后美容效果被评为有所改善（2.1 ± 0.8，评分标准为 -1-3 分）。18 名患者对美容效果表示满意，1 名患者不满意（翻修手术患者），1 名患者失去随访。总之，DTV-FTLC 是一种有效的 FLC 手术方法，患者满意度高，美容效果好。

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引用次数: 0