国际口腔医学杂志 ›› 2017, Vol. 44 ›› Issue (5): 576-579.doi: 10.7518/gjkq.2017.05.016

• 论著 • 上一篇    下一篇

单段腓骨肌皮瓣在修复Ⅱ型上颌骨缺损中的应用

娄慧全, 王卫红, 许彪, 张伯俊   

  1. 昆明医科大学附属口腔医院口腔颌面外科 昆明 650031
  • 收稿日期:2016-10-19 修回日期:2017-04-11 出版日期:2017-09-01 发布日期:2017-09-01
  • 通讯作者: 王卫红,副教授,硕士,Email:wwh2002191@gmail.com
  • 作者简介:娄慧全,硕士,Email:569493937@qq.com
  • 基金资助:
    云南省高等卫生技术学科带头人项目(D-201233)

Subtotal maxillary reconstruction using one vascularized fibular osteomyocutaneous flap segment through modified lateral lip-submandibular approach

Lou Huiquan, Wang Weihong, Xu Biao, Zhang Bojun.   

  1. Dept. of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Kunming Medical University, Kunming 650031, China
  • Received:2016-10-19 Revised:2017-04-11 Online:2017-09-01 Published:2017-09-01
  • Supported by:
    ; This study was supported by Program for Higher Health Technology Academic Leaders Project of Yunnan Province(D- 201233).

摘要: 目的 探讨通过改良口角颌下切口入路及应用单段腓骨肌瓣修复上颌骨次全切除术后Ⅱ型缺损的临床疗效。方法 对11例应用单段腓骨肌瓣修复上颌骨次全切除术后Ⅱ型缺损的患者进行回顾性分析。结果 所有患者切口愈合良好,咬合关系、张口、发音正常,无复视、眼睑外翻、面瘫及下唇感觉麻木等并发症发生。结论 通过改良口角颌下切口入路,应用单段腓骨肌瓣修复上颌骨次全切除后Ⅱ型缺损,该切口美观,术后效果好。

关键词: 上颌骨次全切除术, 改良口角颌下切口, 腓骨肌皮瓣, 三维模拟技术

Abstract: Objective This study demonstrates subtotal maxillary reconstruction using one vascularized fibular osteomyocutaneous flap segment through the modified lateral lip-submandibular approach.Methods Eleven patients who were suffering from subtotal maxillary defects and who underwent maxillary reconstruction using one vascularized fibular osteomyocutaneous flap segment through modified lateral lip-submandibular approach were reviewed. Results Healing courses were uneventful in all cases; furthermore, acceptable maxillomandibular relationship, mouth opening, and speech were assessed as normal in all cases. No long-term functional limitation of the lower limb was reported even though all complained of big toe dysfunction, which eventually developed to a claw toe deformity. Other complications, such as diplopia, ectropion, facial paralysis, and sensory numbness in the lower lip, did not occur.Conclusion Subtotal maxillary reconstruction using one vascularized fibular osteomyocutaneous flap segment through the modified lateral lip-submandibular approach is a feasible and acceptable technique because of multiple advantages.

Key words: subtotal maxillary reconstruction, modified lateral lip-submandibular approach, vascularized fibular flap, three-dimensional virtual technology

中图分类号: 

  • R622+.2
[1] Butler CE, Lewin JS. Reconstruction of large com-posite oromandibulomaxillary defects with free ver-tical rectus abdominis myocutaneous flaps[J]. Plast Reconstr Surg, 2004, 113(2):499-507.
[2] Elsherbiny M, Mebed A, Mebed H. Microvascular radial forearm fasciocutaneous free flap for palato-maxillary reconstruction following malignant tumor resection[J]. J Egypt Natl Canc Inst, 2008, 20(1):90- 97.
[3] Wang JG, Chen WL, Ye HS, et al. Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation[J]. J Craniomaxillofac Surg, 2011, 39(7):499-502.
[4] Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: introducing a new classification[J]. Lancet Oncol, 2010, 11(10):1001-1008.
[5] He Y, Zhu HG, Zhang ZY, et al. Three-dimensional model simulation and reconstruction of composite total maxillectomy defects with fibula osteomyocu-taneous flap flow-through from radial forearm flap [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 108(6):e6-e12.
[6] Rai A, Bhola N, Datarkar A, et al. Modified Weber-Fergusson incision with Borle’s extension[J]. Br J Oral Maxillofac Surg, 2010, 48(5):e23-e24.
[7] Eley KA, Watt-Smith SR. The nasolabial approach: a potential alternative to the lip-splitting incision for maxillectomy[J]. Br J Oral Maxillofac Surg, 2012, 50(1):e6-e8.
[8] Wang WH, Zhu J, Deng JY, et al. Three-dimensional virtual technology in reconstruction of mandibular defect including condyle using double-barrel vascu-larized fibula flap[J]. J Craniomaxillofac Surg, 2013, 41(5):417-422.
[9] Modabber A, Ayoub N, Möhlhenrich SC, et al. The accuracy of computer-assisted primary mandibular reconstruction with vascularized bone flaps: iliac crest bone flap versus osteomyocutaneous fibula flap [J]. Med Devices(Auckl), 2014, 7:211-217.
[10] Rapidis AD, Valsamis S, Anterriotis DA, et al. Func-tional and aesthetic results of various lip-splitting incisions: a clinical analysis of 60 cases[J]. J Oral Maxillofac Surg, 2001, 59(11):1292-1296.
[11] Dziegielewski PT, O’Connell DA, Rieger J, et al. The lip-splitting mandibulotomy: aesthetic and func-tional outcomes[J]. Oral Oncol, 2010, 46(8):612- 617.
[12] Dziegielewski PT, Mlynarek AM, Dimitry J, et al. The mandibulotomy: friend or foe? Safety outcomes and literature review[J]. Laryngoscope, 2009, 119 (12):2369-2375.
[13] 王卫红, 刘宗良, 邹智荣, 等. 腓骨瓣的解剖学研究[J]. 国际口腔医学杂志, 2011, 38(5):509-510, 514.
Wang WH, Liu ZL, Zou ZR, et al. Anatomic study of fibular flap[J]. Int J Stomatol, 2011, 38(5):509- 510, 514.
[14] Vural E, Hanna E. Extended lateral rhinotomy incision for total maxillectomy[J]. Otolaryngol Head Neck Surg, 2000, 123(4):512-513.
No related articles found!
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张新春. 桩冠修复与无髓牙的保护[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[3] 彭国光. 颈淋巴清扫术中颈交感神经干的解剖变异[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 康非吾. 种植义齿下部结构生物力学研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 孟姝,吴亚菲,杨禾. 伴放线放线杆菌产生的细胞致死膨胀毒素及其与牙周病的关系[J]. 国际口腔医学杂志, 2005, 32(06): 458 -460 .
[8] 费晓露,丁一,徐屹. 牙周可疑致病菌对口腔黏膜上皮的粘附和侵入[J]. 国际口腔医学杂志, 2005, 32(06): 452 -454 .
[9] 赵兴福,黄晓晶. 变形链球菌蛋白组学研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 庞莉苹,姚江武. 抛光和上釉对陶瓷表面粗糙度、挠曲强度及磨损性能的影响[J]. 国际口腔医学杂志, 2008, 35(S1): .