颊侧黏膜瓣在牙源性口腔上颌窦瘘修复中的应用  

Application of the buccal flap in the restoration of odontogenic oroantral fistula

作　　者：孙艺渊[1] 许晨婕 王珮华[1] 江璞玉 吴晴伟[1] SUN Yiyuan;XU Chenjie;WANG Peihua;JIANG Puyu;WU Qingwei(Department of Otolaryngology Head&Neck Surgery,Ninth People’s Hospital,School of Medicine,Shanghai Jiaotong University,Ear Institute Shanghai JiaoTong University School of Medicine,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases,Shanghai,200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科,上海交通大学医学院耳科学研究所,上海市耳鼻疾病转化医学重点实验室,上海200011

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第3期211-215,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨颊侧黏膜瓣在牙源性口腔上颌窦瘘修复手术中的临床应用,评价改善鼻腔及口腔相关功能的临床疗效。方法2017年1月~2020年12月收治15例牙源性上颌窦炎合并口腔上颌窦瘘患者,术前所有患者均行高分辨率螺旋CT扫描或CBCT用于评估。实施功能性鼻内镜上颌窦开放手术,同时使用口腔上颌窦瘘邻近的颊侧黏膜瓣修复关闭瘘口。结果115例牙源性上颌窦炎合并口腔上颌窦瘘患者术后随访6~12个月,14例患者瘘口一期愈合,1例患者出现修补创面裂开,使用颊脂垫瓣修复愈合。患者手术前、后鼻部VAS评分均值分别为(6.87±1.51)分和(1.87±0.92)分,口腔健康影响程度量表评分均值分别为(30.07±8.16)和(14.07±3.75),两组数据差异均具有统计学意义(P<0.01)。结论颊侧黏膜瓣作为局部口腔黏膜瓣,应用于口腔上颌窦瘘修复,血运丰富,手术操作简单,成功率高,可改善患者的生活质量,具有重要的临床应用价值。Objective To investigate the clinical application of buccal flap in the restoration of odontogenic oroantral fistula and its significance in improving nasal and oral function,and to evaluate its clinical effect.Methods Fifteen patients with odontogenic oroantral fistula were admitted from January 2017 to December 2020.High-resolution spiral CT scans and Cone beam CT were performed before surgery for preoperative evaluation.Functional endoscopic sinus surgery was performed,and closure of oroantral fistula Using buccal advancement Flap was method for defect repair.Results The nasal and oral function of 15 patients with oroantral fistula were significantly improved after 6 to 12 months of follow-up.Successful restoration in 14 patients,and wound dehiscence was occurred in 1 case,which was repaired with buccal fat pad flap.The mean VAS scores of patients with nasal appearance were(6.87±1.51)preoperatively and(1.87±0.92)postoperatively,and the mean OHIP scores were(30.07±8.16)preoperatively and(14.07±3.75)postoperatively(P<0.01).Conclusion Buccal flap,as an oral local flap,can be applied to the restoration of oroantral fistula and has the advantages of sufficient blood supply,easy operation and a high survival rate,which can effectively improve nasal and oral function and has important clinical application value.

关 键 词：口腔上颌窦瘘 牙源性上颌窦炎 颊侧黏膜瓣 

分 类 号：R782.2[医药卫生—口腔医学]