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作 者:左良 喻建军 周晓 戴捷 田皞 单振锋 胡杰 谌星 王鸿涵 蔡旭 高水超 Zuo Liang;Yu Jianjun;Zhou Xiao;Dai Jie;Tian Hao;Shan Zhenfeng;Hu Jie;Chen Xing;Wang Honghan;Cai Xu;Gao Shuichao(The 2nd Department of Head and Neck Surgery,Department of Oncoplastic Surgery,Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha 410013,China)
机构地区:[1]湖南省肿瘤医院、中南大学湘雅医学院附属肿瘤医院头颈外二科肿瘤整形外科,长沙410013
出 处:《中华整形外科杂志》2019年第7期656-660,共5页Chinese Journal of Plastic Surgery
基 金:湖南省科技计划项目(2013SK3205).
摘 要:目的探讨虚拟手术系统辅助下行颌骨缺损修复重建术的优势.方法2012年1月至2016年12月湖南省肿瘤医院收治25例上、下颌骨肿瘤患者,术前在虚拟手术系统辅助下制作三维打印截骨导板、腓骨塑形板及就位导板,按照肿瘤处理原则,切除颌骨肿瘤后,使用游离腓骨肌皮瓣对上、下颌骨进行修复重建.结果本组25例,2例取同侧腓骨肌皮瓣修复,22例取对侧腓骨肌皮瓣,1例上颌骨Ⅱd类缺损取左侧腓骨肌皮瓣修复.患者均获12~48个月随访,颌骨愈合良好,咬合关系正常,患者对外形均较满意.1例下颌骨重建于术后1年行种植牙修复.结论通过虚拟手术系统辅助,可以缩短手术时间,简化手术过程,可重复性强,使手术医生能够在较短的时间内完整切除肿瘤,对患者上、下颌骨外形进行较完美地修复重建.Objective To review the clinical data of patients who underwent maxillary and mandibular reconstruction with vascularized fibula osteomycutaneous flap, using virtual surgery planning. Methods From January 2012 to December 2016, 23 patients with mandibular defect and 2 patients with maxillary defect were treated in our department. In virtual surgery planning, the optimal osteotomy line and angle were designed. Segmental maxillectomy and mandibulectomy, as well as mandibular reconstruction were performed using guided templates to practice the virtual planning.Actual reconstruction results were compared with those of virtual surgery. Results Among the 25 patients, 2 patients were repaired with the ipsilateral fibula myocutaneous flap, 22 patients were lateral fibula myocutaneous flap. One case of maxillary type Ⅱd defect was repaired with left fibular muscle flap. All patients were followed up for 12 to 48 months. Satisfied bony unions and occlusion were observed in 25 patients.All patients reported excellent or good facial appearance. One of them received dental implants at 1 year postoperatively. Conclusions An ideal contour of maxilla and mandible can be obtained using vascularized fibula osteomycutaneous flap in virtual surgery.
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