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. 2014 Aug;32(4):350-4.
doi: 10.7518/hxkq.2014.04.008.

[Piezosurgery for surgically assisted rapid maxillary expansion under local anesthesia]

[Article in Chinese]
Hao Sun, Biao Li, Hao Sun, Zhixu Liu, Xudong Wang

[Piezosurgery for surgically assisted rapid maxillary expansion under local anesthesia]

[Article in Chinese]
Hao Sun et al. Hua Xi Kou Qiang Yi Xue Za Zhi. 2014 Aug.

Abstract
in English, Chinese

Objective: This study evaluates piezosurgery for surgically assisted rapid maxillary expansion (SARME) under local anesthesia.

Methods: SARME was performed on adults with maxillary transverse deficiency under local anesthesia with a piezosurgical device. Fourteen patients (six males and eight females) underwent lateral maxillary osteotomies, midpalatal osteotomies, and bilateral pterygomaxillary disjunction. The feelings of patients during the operation were determined through questionnaires.

Results: All patients underwent SARME in the out-patient operating room. The surgical procedures were completed under local anesthesia. All patients exhibited satisfactory tolerance. Ultrasonic bone-cutting surgery was recently introduced as a feasible alternative to the conventional tools of cranio-maxillofacial surgery for its technical characteristics of precision and safety. The device used was unique in that cutting action occurred when the tool was employed on mineralized tissues, but stoped on soft tissues. The results of the questionnaires showed that eight (57.14%) patients felt a mild sensation of ultrasonic vibration, tweleve (85.7 1%) felt mild tolerable pain and tooth soreness during surgery, and eleven (78.57%) felt little fear and hardly heard the ultrasonic sound. Preoperative and postoperative six months later measurements showed an evident effect of expansion.

Conclusion: Piezosurgery enabled patients to undergo all the steps of SARME under local anesthesia, but more cases and longer follow-up are needed to verif ' the results.

目的: 探讨采用超声骨刀在局部麻醉下进行外科辅助上颌骨快速扩弓（SARME）手术的可行性。

方法: 选择14例上颌骨横向发育不足的患者（其中男性6例，女性8例）为研究对象，在局部麻醉下用超声骨刀行SARME手术，手术方式采用腭中缝截骨术+侧方骨皮质切开术+双侧翼颌连接截骨术。采用问卷调查方式调查患者的术中感受。

结果: 所有患者的SARME手术均在门诊手术室采用局部麻醉完成，患者均耐受并配合手术。超声骨刀损伤小，可以精确截骨，术后反应小。问卷调查结果显示，术中没有或者仅感觉到轻度震动感的有8例（占57.14%）；术中没有或仅感觉到轻度疼痛和牙齿酸痛的有12例（占85.71%）；对超声骨刀的声音无畏惧感或仅有轻度畏惧感的有11例（占78.57%）。患者术前和术后6个月牙弓宽度的测量值显示手术扩弓的效果非常明显。

结论: 利用超声骨刀在局部麻醉下行SARME手术是可行的，但需要更多病例的实践和更长时间的随访。

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Figures

图 1
图 1. 采用超声骨刀行SARME手术的过程
Fig 1 Using piezosurgery for SARME operation
图 2
图 2. 患者术前（左）和术后6个月（右）的CT片
Fig 2 CT imaging preoperatively (left) and six months postoperatively (right)
图 3
图 3. 患者术前的口内像
Fig 3 Intraoral view preoperatively
图 4
图 4. 患者术后6个月的口内像
Fig 4 Intraoral view six months postoperatively
See this image and copyright information in PMC

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