颊脂垫瓣修复上颌局部组织缺损19例临床分析  

Clinical analysis of 19 cases of maxillary local tissue defects repaired by buccal fat pad flaps

作　　者：刘映坤 李佳[2] 陶博强 闵锋鹤 刘炜炜[1] LIU Yingkun;LI Jia;TAO Boqiang;MIN Fenghe;LIU Weiwei(Second Department of Oral and Maxillofacial Surgery,Hospital of Stomatology,Jilin University,Changchun 130000,China;Department of Oral and Maxillofacial Surgery Out-pa-tient,Hospital of Stomatology,Jilin University,Changchun 130000,China)

机构地区：[1]吉林大学口腔医院口腔颌面外二科,吉林长春130000 [2]吉林大学口腔医院口腔颌面外科门诊,吉林长春130000

出　　处：《口腔疾病防治》2022年第9期658-662,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：吉林省科技计划项目(81602377);吉林大学口腔医院新技术新疗法项目(100779)。

摘　　要：目的探讨应用颊脂垫瓣修复上颌局部组织缺损的效果。方法对19例上颌肿物切除术后口鼻相通、局部缺损范围3.0 cm×2.0 cm~5.0 cm×4.0 cm的患者应用带蒂颊脂垫瓣修复组织缺损,关闭上颌窦腔及口鼻腔相通,并随访3个月观察颊脂垫瓣存活、愈合情况以及是否出现并发症。结果19例患者颊脂垫瓣全部成活。术后5 d颊脂垫瓣呈深红色,稍有水肿,上颌缺损区塌陷;术后10 d,颊脂垫瓣转为粉红色,塌陷减轻;术后1个月,颊脂垫瓣已无明显塌陷,表面发生上皮化,形态、颜色接近正常黏膜,开口轻度受限;术后3个月,颊脂垫瓣已完全上皮化,与周围组织无异,开口度约3横指。19例患者术后3个月内均未出现颊脂垫瓣肿胀坏死、张口受限、口腔上颌窦瘘、口鼻腔相通、面型改变等并发症。结论运用颊脂垫瓣修复直径不大于5 cm的上颌肿瘤术后组织缺损和关闭上颌窦腔具有良好的效果,可在临床推广使用。Objective To investigate the clinical effect of buccal fat pad flaps on the restoration of maxillary defects.Methods Nineteen cases with oral-nasal communications and maxillary soft and hard tissue defects ranging from 3.0 cm×2.0 cm-5.0 cm×4.0 cm after resection of the primary tumor foci were repaired with a pedicled buccal fat pad flap,and the maxillary sinus cavity and oral-nasal communication were closed.The survival,healing and complications of the flap were observed during the 3-month follow-up.Results The buccal fat pad flaps of 19 patients all survived.Five days after the operation,the buccal fat pad flap was dark red with slight edema,and the maxillary defect area collapsed.Ten days after the operation,most of the buccal fat pad flap turned pink,and the collapse was alleviated.One month after the operation,the buccal fat pad flap had no obvious collapse,and its surface was epithelialized,with a shape and color close to those of the normal mucosa.The opening was slightly limited.Three months after the operation,the buccal fat pad flap was completely epithelialized,with no difference from the surrounding tissue,and the opening was approximately 3 transverse fingers.No complications,such as swelling and necrosis of the buccal fat pad flap,limitation of mouth opening,maxillary sinus fistulas,oral-nasal communications and facial changes occurred in 19 patients within 3 months after the operation.Conclusion The application of a buccal fat pad flap has a good effect to repair maxillary tissue defects and close oral maxillary sinus communication with diameters less than 5 cm,so it can be widely used in the clinic.

关 键 词：上颌肿物 腭部多形性腺瘤 腭部黏液表皮样癌 手术切除 上颌窦瘘 口鼻相通 组织缺损 颊脂垫瓣 修复 

分 类 号：R78[医药卫生—口腔医学]