非血管化肋、髂骨移植在下颌骨节段截除术后Ⅰ期重建中的应用  

Immediate reconstruction of mandiblular segmental defects with nonvascularized rib grafts or iliac grafts

作　　者：苟栋明[1] 王明甫[1] 黄旭东[1] 李龙江[2] 

机构地区：[1]四川省巴中市中心医院耳鼻咽喉头颈外科,四川巴中636001 [2]四川大学华西口腔医院颌面外科,四川成都610041

出　　处：《山东大学耳鼻喉眼学报》2014年第4期67-70,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨非血管化肋、髂骨移植在下颌骨节段截除术后Ⅰ期重建中的效果。方法 2004-2012年为16例因骨良性病变导致下颌骨严重破坏者行下颌骨节段截除术后缺损,取自体肋、髂骨游离移植Ⅰ期重建。结果手术切口均Ⅰ期愈合,随访1～24个月,远期并发瘘道及植骨坏死各1例,颌面下份外观及咬合咀嚼功能基本满意,对半侧下颌骨缺损修复病例相对略差但能维持颜面轮廓及进食。结论非血管化肋、髂骨游离移植在下颌骨节段截除术后Ⅰ期重建中手术操作简单,无需血管吻合技术,只要选择好病例适应证、注意手术技巧即能获得较为满意的疗效,在条件相对较差的基层医院仍是修复下颌骨缺损的一种理想方法。在外观及咬合恢复方面,髂骨移植优于肋骨,骨缺损范围大者略差。Objective To explore the effect of stage-I reconstruction with nonvascularized rib grafts or iliac grafts post mandibular segmental resection. Methods The analysis was based on the 16 patients admitted in our hospital from2004 to 2012. They developed with severe mandiblular defects resulting from benign tumors and mandibular segmental resection and were chosen to undertake stage-I reconstruction with autologous nonvascularized rib grafts or iliac grafts.Results Incisions of all cases recovered in phase I. During the follow-up period of 1 to 12 months,one case of fistula and one case of graft necrosis were observed in all cases. All grafted bones survived with satisfied occlusions and appearances. The effects of the cases with half mandible defects were also accepted with appearance repair and basic occlusive function. Conclusion Satisfactory effect can be achieved by applying nonvascularized rib or iliac grafts to stage-I postoperative reconstruction post mandibular segmental resection. The operative procedure is relatively simple and no vascular anastomosis technique is needed. Taken together,it makes nonvascularized rib or iliac grafts to be an applicable method of mandibular defect repairing.

关 键 词：非血管化骨移植 下颌骨 肋骨 髂骨 重建 缺损 

分 类 号：R782.23[医药卫生—口腔医学]