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目的:探讨数字化设计在下颌角不对称肥大诊断及手术治疗中的应用价值。方法:回顾性分析2010年12月至2020年12月中国医学科学院整形外科医院数字化整形外科收治的汉族女性下颌角不对称肥大患者的临床资料。术前用ProPlan CMF 3. 0软件对患者的三维模型做镜像处理，得出诊断，评估不对称性下颌骨两侧的差异特征，据此采用合适的手术方法进行治疗。通过下颌角点宽度（Go-W)、髁突顶点高（Co-H）及下颌角度（Ag）等指标对手术效果进行客观评价。采用SPSS 18. 0进行统计分析，数据行Kolmogorov-Smirnov检验，结果符合正态分布，以n ±n s表示，采用配对n t检验比较下颌骨两侧各指标测量结果，n P<0. 05为差异具有统计学意义。n 结果:共纳入30例先天性下颌角不对称肥大患者，均为女性，年龄18~ 39岁。术前三维模型测量结果显示其下颌骨一侧下颌升支更长（长侧），另一侧下颌角更向外侧突出（突侧），采用改良的下颌角截骨手术方法进行治疗。长侧的截骨线高度为突侧截骨线高度+两侧高度差，突侧的外板打磨厚度为长侧的外板打磨厚度+两侧宽度差。术前颏前点和颏下点均远离下颌骨长侧，而偏向突侧。下颌骨两侧标记点的高度、宽度及Ag比较，差异均有统计学意义(n P<0. 01)，其中Go-W、Co-H、Ag不对称差值最大，可用于评价手术效果。30例患者下颌骨长侧Go-W、Co-H、Ag术前与术后的差值分别为(1. 10±2. 05) mm、(12. 84±2. 96) mm、(-17. 75±5. 16) °，突侧上述3个指标差值分别为（4. 24±1. 64) mm、(10. 95± 3. 25) mm、(-14. 87±5. 14) °，术前、后比较差异均有统计意义(n P0. 05)。所有患者术后均无血肿、感染等并发症，患者均对手术效果表示满意。n 结论:下颌角不对称肥大可通过患者术前三维重建模型进行设计，精确测量下颌骨两侧的差异，并能有效指导手术方式，提高患者双侧下颌骨的对称性，面部达到较好的美学效果。“,”Objective:To investigate the application value of the diagnostic and surgical method for asymmetric prominent mandibular angle assisted by digital surgical design.Methods:The data of the females in Han nationality with prominent mandibular angle from December 2010 to December 2020 in the Department of Digital Plastic Surgery of Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. ProPlan CMF 3. 0 software was used to preoperatively mirror the patient’ s three-dimensional (3D) model to obtain a diagnosis.The characteristics of bilateral differences of asymmetry of mandible were evaluated, and the surgical method were analyzed. The effect of surgery was objective ly evaluated by indicators such as mandibular corner point width (Go-W) , condyle apex height (Co-H) , and mandibular angle (Ag ). SPSS 18. 0 was used for statistical analysis, and the data were tested by Kolmogorov-Smirnov, and the result were in line with the normal distribution. The data were expressed in Mean±SD, and the paired n t-test was used to compare the measurement result of the indicators on both sides of the mandible, and n P< 0. 05 was a statistically significant difference.n Results:A total of 30 cases, aged from 18 to 39 years, were included. Preoperative 3D model measurements showed a longer mandibular ascending branch on one side of the mandible (long side) and a more extrusion of the mandibular angle on the other side (protruding side) , which was treated with a modified surgical method of mandibular angle osteotomy. The height of the osteotomy line on the long side was the height of the exuberant osteotomy line + the height difference between the two sides, and the thickness of the outer plate grinding on the protrusion side was the thickness of the outer plate grinding on the long side + the width difference between the two sides.Both the preoperative anterior and subtignan points were far from the long side of the mandible and biased towards the synaptic side.The height, width and mandibular angle of the marker points on both sides of the mandible were compared, and the differences were statistically significant (n P< 0. 01 ). Among them, the asymmetrical difference between Go-W, Co-H and Ag was the largest, which can be used to evaluate the effect of surgery.The differences between go-W, Co-H and Ag before and after surgery on the long side of the mandible were (1. 10 ± 2. 05) mm, (12. 84 ± 2. 96) mm, (-17. 75 ± 5. 16) ° , and the differences between the three indicators on the synaptic side were (4. 24±1. 64) mm, (10. 95±3. 25) mm, (-14. 87±5. 14) °, respectively, and the differences between preoperative and postoperative comparisons were statistically significant (n P 0. 05) . All patients had no complications such as hematoma and infection after surgery, and the patients were satisfied with the result of the operation.n Conclusions:Asymmetric hypertrophy mandibular angle can be reconstructed by the patient’s preoperative 3D model to accurately measure the differences between the two sides of the mandible.This design can effectively guide the surgical method , improve the symmetry of the patient’ s bilateral mandible, and achieve better aesthetic effects on the face.