基于修复理念的单侧游离腓骨肌皮瓣同期重建上下颌骨缺损  

Simultaneous reconstruction ofmaxillary andmandibular defectswith one single free fibulamyocutaneous flap base on restoration concept

作　　者：茅传青 王承勇[1] 卢萌[1] 赖永圳 蔡志宇[1] 陈伟辉[1] MAOChuan-qing;WANGCheng-yong;LUMeng;LAIYong-zhen;CAIZhi-yu;CHENWei-hui(Department of Stomatology,UnionHospitalAffiliatedto FujianMedicalUniversity,Fujian 350001,China)

机构地区：[1]福建医科大学附属协和医院口腔科,福建350001

出　　处：《口腔颌面修复学杂志》2020年第5期291-294,共4页Chinese Journal of Prosthodontics

基　　金：福建省教育厅中青年教师课题(项目编号:JAT170225#)。

摘　　要：目的:探讨单侧游离腓骨肌皮瓣修复重建同侧上下颌骨缺损为义齿修复奠定基础方法的可行性。方法:回顾性研究2016年1月至2017年6月期间就诊于福建医科大学附属协和医院的患者并采用单侧游离腓骨肌皮瓣同期重建上下颌骨缺损的病例信息,全面分析患者的基本信息、临床特征、病例诊断、治疗方式以及术后并发症等相关信息。结果:4位患者在此期间应用单侧游离腓骨肌皮瓣同期重建上下颌骨缺损,其中3位患者病理诊断为鳞状细胞癌,另1位患者病理诊断为骨化性纤维瘤;四位患者颌骨缺损范围均不同程度涉及同侧上下颌尖牙远中区域,术中血管吻合均采用腓骨动脉与颌外动脉吻合、腓骨静脉与颈外静脉吻合的方式,平均手术时长7小时,皮瓣最大制取面积约10cm×6cm。术后1例患者皮瓣发生静脉血栓,其余患者皮瓣存活良好,所有患者术后张口度与术前无明显变化。所有患者在随访期间腓骨供区愈合良好,未见明显并发症。结论:采用单侧游离腓骨肌皮瓣同期重建同侧上下颌骨缺损是一种相对可行的外科修复重建手段,有利于义齿修复。Objective:To explore the feasibility of simultaneous reconstruction of the maxillary and mandibular defects with one single free fibulamyocutaneous flaptomake a foundation for denture restoration.Methods:A retrospective study was performed to analyze the patient who received the treatment of one single free fibula myocutaneous flap to simultaneously reconstruct themaxillary andmandibular defects at theUnionHospital affiliated to FujianMedicalUniversity from2016.01 to 2017.06.Comprehensive analysis of patients’basic information,clinical features,case diagnosis,treatment methods,postoperative complications and other relevant information.Results:During this period,four patients undergone tissue defects reconstruction for the same sidemaxillary andmandibulectomywith one single free fibulamuscle flap.Three of themwere diagnosed as squamous cell carcinoma and the other one as ossifying fibroma.The jawdefects of the four patients all involved the distal area of the ipsilateralmaxillary canine to varying degrees.The intraoperative vascular anastomosis used the fibular artery and the externalmandibular artery,the fibular vein and the external jugular vein.Themean operation timewas 7 hours,and themaximumflapwas 10 cm*6 cm.One patient’s flap experienced venous thrombosis and the otherwerewell survival.Therewas no significant change in the postoperativemouth opening of all patients.No donor site complicationswere observed in all four patients.Conclusion:One single free fibula myocutaneous flap would be a relatively feasible method for simultaneously reconstruct themaxillary andmandibular defect,which is beneficial to denture restoration.

关 键 词：腓骨肌皮瓣 颌骨重建 上下颌骨缺损 

分 类 号：R782.14[医药卫生—口腔医学]