腓骨肌皮瓣重建下颌骨缺损的临床研究  

Clinical research on reconstruction of mandibular defect with fibula myocutaneous flaps

作　　者：范亚伟[1] 王晓飞[1] 齐鸿亮[1] 范慧芳[1] 

机构地区：[1]山西医科大学第一临床医学院口腔科,太原030001

出　　处：《山西医科大学学报》2015年第5期495-496,500,506,共4页Journal of Shanxi Medical University

基　　金：山西省社会发展科技攻关计划资助项目(20120313021-9)

摘　　要：目的探讨因肿瘤致下颌骨缺损后,采用腓骨肌皮瓣重建下颌骨,并评估修复后患者外形及功能。方法对5例因肿瘤切除部分下颌骨而造成下颌骨缺损的患者行腓骨肌皮瓣双叠移植术,术前通过Simplant软件重建缺损下颌骨并在计算机上设计腓骨肌皮瓣的塑形位点,术后观察,定期随访,并评估患者外形及余留牙的咀嚼功能。结果 5例游离腓骨肌皮瓣全部成活,4例修复后面部外形对称、咬合关系良好、临床效果满意,测定咀嚼效率恢复良好,1例患者术后3个月术区牙龈出现红肿疼痛,经局部冲洗及抗炎治疗2周后,炎症减轻,1周后颜色恢复正常。结论采用腓骨肌皮瓣手术是修复下颌骨缺损的可靠方法之一。计算机软件辅助设计骨缺损的范围,可以有效恢复颌面部外形及功能。Objective To evaluate the facial appearance and masticatory function after reconstruction of mandibular defect caused by tumor with the fibula myocutaneous flap. Methods Five patients with mandibular defect due to removal of part of mandible caused by tumor underwent fibula myocntaneous flap double stack transplantation to reconstruct the mandibular defect after designing and locating the shape point of the fibula myocutaneous flap using Simplant software before surgery. The patients were followed-up to evaluate the pa- tients ＇ appearance and masticatory function of the maintained teeth. Results All free fibula myocutaneons flaps were successfully sur- vived in 5 patients. Four patients regained symmetrical facial appearance, well occlusal relationship, satisfied clinical effect and well masticatory efficiency. One patient＇ s gums in surgical spot showed swelling and pain at 3 month after the surgery. After local irrigating and anti-inflammatory treatment for two weeks, the inflammation of the gums relieved and the color returned to normal after 1 week. Conclusion Fibula myocutaneous flap surgery is one of the reliable methods to repair the mandibular defects. The computer-aided soft- ware for designing the range of bone defect can effectively help to restore the facial appearance and masticatory function.

关 键 词：下颌骨缺损 腓骨肌皮瓣 计算机辅助设计 咀嚼效率 

分 类 号：R782.2[医药卫生—口腔医学]