偏側性 下顎巨大症으로 因한 非對稱顔貌의 外科的 顎矯正 一例

A case of asymmetric macrognathia corrected by simultaneous maxillary & mandibular osteotomy

The unilateral macrognathia is one of the asymmetric mandibular excesses involving entire half of the mandible and results in compensatory maxillary deformity. This is to report a case of unilateral macrognathia of a 23-year-old female. The asymmetric facial deformity was corrected by simultaneous maxillary and mandibular osteotomies. The results are summarized as follows. 1. Cephalometric lateral analysis disclosed general prognathia with 85.7˚ of SNB, -2˚ of ANB, 82% of post./ant. facial height, and Rt-Lt analysis revealed remarkable asymmetricity with 14㎜ difference of facial height, 12㎜ difference of ramus height and 11㎜ difference of mandibular body height. 2. This deformity was corrected by one-visit intra-orally operation ; the maxillary Le Fort I osteotomy with a bone graft, sagittal split osteotomy and bone reduction of excessively-grown-mandibular body. 3. During the mandibular ostectomy, Lt. mental nerve was teared but the tactile sense of the lip was recovered in 4 months after the micro-suture of avulsed nerve. 4. The prognosis was uneventful until 1 year after the operation without any relapsed disfigurement