下颌骨缺损的修复与重建  

Restore and reconstruction of the mandibular de-fects

作　　者：蔡志刚[1] 张杰[1] 张建国[1] 赵福运[1] 林野[1] 郭传瑸[1] 于国霞[1] 钱三楼[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,北京100081

出　　处：《中国耳鼻咽喉头颈外科》2004年第5期285-287,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：首都医学科研发展基金资助项目(ZD199805)

摘　　要：目的 探讨4种下颌骨修复与重建技术临床应用的适应证。方法 对135例下颌骨缺损修复与重建病例的病因及分类、采用的修复与重建的方法以及影响选择修复技术的因素进行回顾性分析。结果 该组病例中,男性患者约为女性的2倍,年龄从14岁至82岁,中位年龄45岁。病变性质良、恶性各半,缺损类型以半侧下颌骨缺损和单纯下颌骨体部缺损居多,单纯的下颌升支缺损及下颌骨方块缺损病例较少。结论 年龄及病变性质已不再是是否行下颌骨修复重建的决定因素。4种修复方法各有其特点及适应证:血管化游离腓骨移植适用于较大缺损或伴软组织缺损的各类下颌骨缺损畸形;游离髂骨移植适用于良性病变导致的长度在6 cm以内的单区缺损或方块植骨;重建钛板则适用于多次复发的恶性病变导致的颌骨缺损的姑息性修复;骨牵引成骨则最适合于下颌骨方块缺损的病例。OBJECTIVE To study the clinical indica-tions of 4 kinds of methods for mandibular restore andreconstruction. METHODS One hundred and thirty-fivecases with various mandibular defects were includedin this study. Etiology and classification of the man-dibular defects, the restore and reconstructive meth-ods and the influence factors were retrospectiveanalyzed. RESULTS In all of 135 cases, the ratio ofmale and female was 2:1, the range of age was from14 to 82 years old with median age 45 years. Benignand malignant lesions were respectively half of all ofcases, and the most of mandibular defects were a halfof mandible defect and simple mandibular body defect,but the ramus defects and the mandibular block de-fects were very rare. CONCLUSION The age and patho-logical classification of the lesions are not the key pointagain for the mandibular restore and reconstruction now.There were different characteristics and indications inthe four kinds of methods: free vascular fibular flap isthe best reconstructed method for the larger defects ofmandible or with soft tissues defects; autologous non-vascularized free iliac is used in block bone graft or thelength of mandibular defect is under 6 cm resulted bybenign lesions; reconstructive titanium palate is usedin recurrence malignant lesions; distraction osteogen-esis maybe suitable to block defects of mandible.[

关 键 词：下颌假体植入 修复 外科手术 下颌骨缺损 

分 类 号：R782[医药卫生—口腔医学]