A retrospective controlled clinical study of the mortice and tenon joint and end-to-end bone contact on the zygomatic arch in reduction malarplasty
10.3760/cma.j.cn114453-20220510-00142
- VernacularTitle:颧骨颧弓缩窄术中颧弓根部榫卯结构与端对端接触连接的对比研究
- Author:
Guizheng CHEN
1
;
Yuchun XU
;
Ping LI
;
Lu LIU
;
Jihua LI
Author Information
1. 四川友谊医院医疗美容科，成都 610066
- Keywords:
Zygoma;
Zygomatic arch;
Reduction malarplasty;
Mortice and tenon joint;
End-to-end bone contact
- From:
Chinese Journal of Plastic Surgery
2023;39(1):1-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical effects of mortice and tenon joint and end-to-end bone contact of zygomatic arch in reduction malarplasty, and to explore the clinical application value of mortice and tenon joint.Methods:The clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital and West China Hospital of Stomatology, Sichuan University from January 2013 to June 2020 were analyzed retrospectively. All patients were treated with classical or modified L-shaped zygomatic arch osteotomy. According to the bone connection mode of the zygomatic arch, the patients were divided into Group Ⅰ and Group Ⅱ. The patients in Group Ⅰ were treated with mortice and tenon joint (from June 2017 to June 2020), and the ones in Group Ⅱ were treated with end-to-end contact (from January 2013 to May 2017). The movement between zygomatic body and zygomatic arch were measured 6-24 months after surgeries. The postoperative satisfaction rate was investigated, and the incidence of complications within 2 years after operation was recorded. The data were statistically analyzed by SPSS 20.0 software. The measurement data were expressed by Mean±SD, and the counting data were expressed by cases (%). T-test was used to compare the age difference, zygomatic body and zygomatic arch movement distance between the two groups. Chi-square test was used to compare the sex composition ratio, postoperative satisfaction rate (sum of very satisfied and satisfied cases/sum of cases in respective group) and incidence of complications between the two groups. P<0.05 was considered statistically significant. Results:A total of 380 patients presenting with zygomatic protrusion were included in this retrospective study. One hundred and ninety patients were included in Group Ⅰ[22 men and 168 women; aged(26.8 ±8.6) years)] and 190 patients in Group Ⅱ [16 men and 174 women; aged (25.2 ±8.8) years)]. There was no significant difference in sex constituent ratio and age between the two groups ( P>0.05). After the operation, the width of the face was narrowed, and the contour of the face was significantly improved. The medial movement distance of zygomatic body in Group Ⅰ and Group Ⅱ was (2.65±0.76) mm versus (2.51±0.78) mm, and the movement distance of zygomatic arch in Group Ⅰ and Group Ⅱ was (4.58 ±0.44) mm versus (2.60±0.28) mm. There was no significant difference in movement distance of zygomatic body between Group Ⅰ and Group Ⅱ ( t=1.77, P=0.077), but there was significant difference in the zygomatic arch ( t=52.33, P<0.001). The satisfaction rate of patients in Group Ⅰ was 75.8% (144/190), which was higher than that in Group Ⅱ (55.3%, 105/190) ( χ2=17.72, P<0.001). There was no significant difference in the incidence of postoperative infection, temporary paresthesia, and hematoma between the two groups ( P>0.05). The incidence of facial asymmetry, sagging cheek, bone suture and nonunion in Group Ⅱ was significantly higher than that in Group Ⅰ ( P<0.05). Conclusion:Compared with end-to-end bone contact in reduction malarplasty, the mortice and tenon joint of the zygomatic arch achieved better facial narrowing effect and long-term stability, higher patient satisfaction rate and less postoperative complications.
