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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제59권 제6호
발행연도
2018.1
수록면
793 - 797 (5page)

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Patients who have a lower facial asymmetry with compensatory head posture (developmental facial asymmetry) may have minortemporomandibular (T-M) joint problems and tend to mask their asymmetry by tilting the head for camouflage of their chin deviation. However, this compensatory head posture can give the impression of orbital dystopia and c spine deviation. When thesepatients undergo bimaxillary orthognathic surgery, orbital canting and head tilting improves gradually without the need for camouflage,and bleary eyes become clearer. We evaluated 13 patients who underwent LeFort I osteotomy combined with bilateralsagittal split osteotomy of the mandible for developmental facial asymmetry to quantitatively observe whole facial posturalchanges after surgery. Pre-operative and post-operative 1:1 full-face photographs of the patients were analyzed to compare thedegrees of head tilting and orbital canting and the sizes of the eye opening. After bimaxillary orthognathic surgery, eye cantingdecreased from 2.6° to 1.5°, eye and lip lines came closer to parallel, and the degree of head tilting decreased from 3.4° to 1.3°. Theeyes also appeared to open wider. Correction of lower facial skeletal asymmetry through bimaxillary orthognathic surgery improvedhead tilting and orbital canting gradually by eliminating the need of compensatory head posture. Facial expressions alsochanged as the size of the eyes increased due to the reduction of facial muscle tension caused by T-M joint dysfunction.

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