颞肌蒂下颌骨瓣联合前臂皮瓣一期修复腭上颌缺损  

Immediate reconstruction of palatomaxiilary defects by mandibular osteomuscular flap pedicled withtemporalis and radial forearm free flap

作　　者：张凯[1] 徐涛[1] 徐锦程[1] 高廷益[1] 刘亮[1] 路晓淼[1] 卢保全[1] 

机构地区：[1]蚌埠医学院第一附属医院口腔颌面外科,安徽省蚌埠市233004

出　　处：《中华显微外科杂志》2012年第4期272-275,I0004,共5页Chinese Journal of Microsurgery

基　　金：安徽省卫生厅资助项目（20088016）

摘　　要：目的探讨颞肌蒂下颌骨瓣与游离前臂皮瓣联合修复腭上颌缺损的临床疗效。方法2008年3月至2011年3月，共收治恶性肿瘤切除后腭上颌缺损9例，其中男6例，女3例，年龄34-68岁，平均57岁。根据Browm上颌骨缺损分类，其中ⅡB类8例，ⅡC类1例。均采用颞肌蒂下颌骨瓣与游离前臂皮瓣联合修复。结果9例移植的骨瓣及皮瓣均成活。随访期10-24个月，平均随访期14个月，除1例软骨肉瘤病例术后复发外，其余病例的面部外形和功能均恢复满意，供区未见并发症。结论应用颞肌蒂下颌骨瓣与游离前臂皮瓣联合修复腭上颌缺损具有操作简单易行、安全可靠和并发症少等优点，是修复上颌骨缺损的较理想术式。Objective To evaluate the clinical effect of mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap to repair palatomaxillary defects. Methods From March 2008 to March 2011, nine patients with palatomaxillary defects following malignant tumor ablation, were repaired with mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap. According to Brown＇s classification for the maxillectomy defect, eight cases were type Ⅱ B and 1 case was type Ⅱ C. There were 6 males and 3 females with an average age of 57 years（range, 34-68 years）. Results All the 9 osteomuseu- lar flaps and forearm flaps survived. The patients were followed up for 12 to 24 months with an average of 14 months. The patients acquired satisfactory appearance and complete functional restoration except 1 case of chondrosarcoma of recurrence was encountered 6 months after operation. Conclusions Palatomaxillary defects were reconstructed by mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap immediately. It is easy to elevate, safe, and there were no donor site problems. This is an ideal method of repairing the palato maxillary defects.

关 键 词：前臂皮瓣 颞肌蒂下颌骨瓣 腭上颌缺损 重建 

分 类 号：R782.2[医药卫生—口腔医学]