腹内斜肌-髂骨复合组织瓣修复半侧下颌骨缺损  

Vascularized composite flap with iliac crest and internal oblique muscle of abdomen for half mandibular reconstruction

作　　者：夏德林[1] 付光新[1] 马征[1] 吴双江[1] 张磊[1] 贾娟[1] 

机构地区：[1]泸州医学院附属医院口腔颌面外科,646000

出　　处：《中华整形外科杂志》2015年第2期85-88,共4页Chinese Journal of Plastic Surgery

基　　金：四川省科技厅应用基础研究项目（2008jy001）

摘　　要：目的 探讨腹内斜肌-髂骨复合组织瓣在半侧下颌骨缺损修复中的效果.方法 2009年7月至2013年9月,应用以旋髂深动、静脉为蒂的腹内斜肌-髂骨复合组织瓣,对14例因肿瘤切除所致的半侧下颌骨缺损进行修复.手术分2组同时进行,一组切除肿瘤并准备受区血管,一组切取腹内斜肌-髂骨复合组织瓣.将制备好的组织瓣修整塑形固定后吻合血管.结果 14例腹内斜肌-髂骨复合组织瓣均存活,1例受区伤口局部感染,经换药后痊愈.切取髂骨最小6 cm×3 cm,最大9 cm×3 cm,腹内斜肌瓣最小5 cm×4 cm,最大7 cm×5 cm.术后随访6～ 26个月,平均13个月,颌面部外形满意、双侧对称,供区未见并发症.下颌曲面断层片显示移植髂骨断端新骨形成良好、下颌骨连续,骨纹理清晰.结论 腹内斜肌-髂骨复合组织瓣具有骨量充足、重建下颌骨高度足够、外形功能恢复好、软硬组织同期重建等优点,是修复半侧下颌骨复合组织缺损的较好方法.Objective To investigate the effect of vascularized composite flap with iliac crest and internal oblique muscle of abdomen for half mandibular reconstruction.Methods From July 2009 to Sept.2013,14 cases with half mandibular defect after tumor resection were treated with composite flap of iliac crest and internal oblique muscle of abdomen pedicled by deep circumflex iliac vessels.During operation,one group performed tumor resection and got the recipient area vessels ready for anastomosis.The other group performed harvesting of composite flap.Then the flap was trimmed and fixed to construct the defect with vessel anastomosis.Results All the 14 composite flaps survived with local infection only in 1 case.The size of harvested iliac crest ranged from 6 cm × 3 cm to 9 cm× 3 cm.The size of harvested internal oblique muscle of abdomen ranged from 5 cm× 4 cm to 7 cm× 5 cm.The patients were followed up for 6 months to 26 months （mean,13 months） with satisfactory results and no complication.Mandibular panoramic radiographs showed new bone formation and good union.Conclusions Vascularized composite flap with iliac crest and internal oblique muscle of abdomen has the advantages of abundant bone volume,as well as soft tissue reconstruction in one stage.The reconstructed mandible can attain normal function and appearance.

关 键 词：髂骨 腹内斜肌 缺损 下颌骨 

分 类 号：R782.2[医药卫生—口腔医学]