应用岛状腭黏骨膜瓣联合邻近软组织瓣修复大型获得性口鼻瘘的临床研究  

Clinic Trial of Utilization of Palatal Island Flap in Combination with Adjacent Soft Tissue Flap for Closure of Large Acquired Oro-nasal Fistula.

作　　者：徐泽东 孙国文[1] XU Zedong;SUN Guowen(Department of Oral and Maxillofacial Surgery,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Research Institute of Stomatology,Nanjing University,Nanjing 210008,China.)

机构地区：[1]南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,南京大学口腔医学研究所,江苏南京210008

出　　处：《口腔医学研究》2024年第8期722-726,共5页Journal of Oral Science Research

摘　　要：目的:评价应用岛状腭黏骨膜瓣联合邻近软组织瓣,双层封闭大型Ⅳ型获得性口鼻瘘的临床效果。方法:收集南京大学医学院附属口腔医院口腔颌面外科一病区2017年1月至2021年12月收治的大型(最大径大于5 mm)Ⅳ型(硬腭)获得性口鼻瘘患者8例,患者年龄24~68岁。回顾性分析应用岛状腭黏骨膜瓣联合腭缘瓣(和)颊肌黏膜瓣双层封闭缺损,术后随访对疗效进行前瞻性评估。结果:全部病例修复成功,未见软组织瓣坏死、穿孔、感染及鼻窦炎,随访24个月未见鼻腔反流及上呼吸道感染,语音及咀嚼吞咽功能恢复良好。结论:在恰当适应证下,岛状腭黏骨膜瓣联合邻近软组织瓣是方便可靠的修复大型Ⅳ型获得性口鼻瘘方法,值得临床推广。Objective:To investigate the clinical effect of a double-layer closure of large typeⅣacquired oro-nasal fistula(AONF)using palatal island flap combined with adjacent soft tissue flap.Methods:Eight patients with large(maximum diameter greater than 5 mm)typeⅣ(hard palate)AONF admitted to Ward 1 of the Department of Oral and Maxillofacial Surgery,Affiliated Hospital of Medical School,Nanjing University from January 2017 to December 2021 were collected,with age ranged from 24 to 68 years old.A retrospective analysis was performed on the double-layer closure of the defect using palatal island flap combined with palatal margin flap(and)buccal myomucosal flap,and the efficacy was prospectively evaluated at postoperative follow-up.Results:All cases were successfully repaired,and no soft tissue flap necrosis,perforation,infection,or sinusitis was found.No nasal regurgitation,or upper respiratory tract infection was found during the 24-month follow-up,and the function of speech,mastication,and deglutition recovered well.Conclusion:Palatal island flap combined with adjacent soft tissue flap is a convenient and reliable modality for large typeⅣAONF if used under appropriate indications,and is worthy of clinical promotion.

关 键 词：获得性口鼻瘘 岛状腭黏骨膜瓣 腭缘瓣 颊肌黏膜瓣 

分 类 号：R782.2[医药卫生—口腔医学]