比較兩種不同鼻翼縫合術式於骨性三級異常咬合接受雙顎正顎手術後之唇鼻形初期變化

Comparison of The Initial Nasolabial Changes by 2 Different Alar Base Cinch Suture Techniques 82 in Class III Patients Who Received Two-Jaw Orthognathic Surgery

探討雙顎正顎手術的病人，接受兩種不同鼻翼縫合術後短期唇鼻形的變化。研究對象與方法：本前瞻性、盲性、隨機臨床試驗研究為32位經診斷為嚴重骨性三級異常咬合型態並接受雙顎正顎手術的成年病患。在平均隨機分配至傳統與改良型鼻翼縫合手術等兩組後，經重疊手術前後（T0：手術前；T1：手術後4-6周）的斷層掃描與三維照片等立體影像後，分析唇鼻位置軟硬組織各參數術前術後的變化。研究結果：傳統組組內術前術後唯一有顯著性差異的為唇鼻角（NLA）增加，改良組組內術前術後白唇高，紅唇高，總唇長，與唇鼻角（NLA）均顯著性增加；兩組組間的各參數均無顯著差異。結論：術後短期鼻唇形的變化兩組均無顯著差異，仍需要較長期追蹤來評斷鼻翼縫合手術的穩定性。

This study compared the effectiveness of the conventional and a new modified alar base cinch technique on changes in the nasolabial morphology after bimaxillary orthognathic surgery. Materials and methods: The prospective, blinded, randomized controlled study recruited 32 Taiwanese skeletal Class III patients (aged 18- 37 years). All of the patients had received bimaxillary orthognathic surgery to correct skeletal discrepancies. During the intraoral wound-closing procedure, patients were equally separated into 2 groups. A conventional group (C, 16 patients) received the conventional alar base cinch technique; a modified group (M, 16 patients) received the modified alar base cinch technique. The nasolabial region was measured both before ( T0 ) and 4-6 weeks (T1) after the operation with the use of cone-beam computerized tomography (CBCT) imaging and 3dMD stereogrammetry. Results: In the conventional group, only the nasolabial angle increased by 8.01°significantly; In the modified group, not only the nasolabial angle increased by 9.06° significantly, but the cutaneous height of the upper lip, the overall upper lip height, and the vermillion height of the upper lip also increased significantly after surgery. The intergroup difference of all parameters showed no significant different. Conclusion: The shortterm treatment effects indicated that no significant difference exists between the 2 different suture techniques. Long-term results are required to illustrate the stability of the alar base cinch technique.