Clinical Anatomic Study On The Plastic Surgery Of Mandible

Clinical Anatomic Study on the Plastic Surgery of the mandiblePhD. Candidate: LIAO Jinmin Supervisor: Prof. ZHONG ShizhenInstitute of Clinical Anatomy, The First Military Medical University, Guangzhou 510515Background: The mandibular deformities such as mandibular prognathism or retrognathism, micrognathia, prominent mandibular angles and masseter muscle hypertrophy, and so on, not only would be corrected, but also be carried out aesthetic plastic surgery during the mandibular osteotoctomies. However, such common complications as the injury of inferior alveolar nerve, bone fracture and bleeding would be occurred in surgical procedure, and the injuries of the facial nerve, the transverse facial vessels, parotid duct and masseteric nerve and vessels, etc. would be happened at times. It was believed that many causes had been responsible for the complications, one of the important causes was less understandings for the mandible and its adjacent structures.The aims of this study were to explore the mandible and its adjacent structures and to develop donors repairing facial nerve defects, so as to provide the applied basic theories for the mandibular osteotomy being better performed and making these complications as less happen as possible, and to provede a new nervous donors for the facial nerve defects, too. Part one:The mandible osteometry related to mandibular osteotomy and its clinical significancesObjective: To measure bony indices related to mandibular osteotomy and explore their clinical significance, so as to provide morphological data-6-for avoiding the occurrence of complications when osteotomy of mandibular ramus was clinically performed.Methods: 100 dry and 10 transplant adult mandibles, which were undamaged on their surfaces, were measured by using the human surveying instrument and referring to surveying methods described by the human surveying handbook.Results: The length, height and thickness of the mandibular body, the height of symphysis, the height and the minimum breadth of the mandibular ramus, the bicondylar breadth, the mandibular angle and the bigonial breadth were72.0?.4mm 27.7?.3mm, 15.0?.7mriK 33.4?.7mm, 61.1?.7mm 32.6?.2mnu 120.4?.6mnu 124.9?.5? 100.2?.8mm, respectively; and the distance from the superior margin of the mandibular foramen to the lowest point of the notch, the distance from the posterior margin of the mandibular foramen to the posterior margin of the ramus, the distance from the anterior margin of stylomastoid foramen to the posterior margin of the mandibular ramus, the distance from the prominent point of the mandibular angle to canal were 15.8?.3mm . 13.1?.9mm . 16.2?.2mm and 20.4?.2mm, separately.Conclusion: The bony indices not only increase anatomic data, but can provide morphological basis when osteotomy of mandibular ramus was clinically performed. Part two:The applied anatomy on the operative approach of the mandibular osteotomyObjective: Further to explore the tissue structures of the superficial face on the masseteric region of mandible and to provide anatomic basis for avoiding damage of its important structures when osteotomy of mandibular ramus was clinically performed.Methods: Red latex or carbonic black ink containing 5% gelatin was injected into the arteries on 18 adult head specimens by both common carotid artery catheterization. The tissue structures of the superficial part of the-7-mandibular ramus were observed and measured.Results: The tissue structures of the superficial part of the mandibular ramus, from superficial to deep layer, were as follows: the skin, subcutaneous tissue, the superficial musculoaponeurotic system (SMAS), parotideomasseteric fascia, masseter, spaces of submasseter and periosteum of mandible. The distances on the superficial face of the masseter from the, zygomatic branch, transverse facial artery, superior buccal branch, parotid duct, inferior buccal branch, marginal mandibular branch and cervical branch to mandibular angle were 5.80.5cnK 5.20.5cm5.1?.6cnu 4.30.5cm, 3.30.8cm 0.9?.5cm...