摘要
目的:总结应用腓骨肌皮瓣整复口腔下颌骨复合缺损的经验。方法:15例下颌骨肿瘤手术后缺损采用吻合血管的游离腓骨肌(皮)瓣进行修复重建,其中9例腓骨肌瓣,6例腓骨肌皮瓣。4例下颌骨颏部缺损,将腓骨截成2～3段修复颏部形态,其中1例伴有口底黏膜和颏部皮肤复合洞穿缺损,应用双皮岛腓骨皮瓣同时修复骨缺损以及口腔衬里和皮肤覆盖;5例下颌体部和升支缺损,将腓骨截成2段形成下颌角;6例下颌体部缺损用1段腓骨修复,其中1例骨整合种植体即刻植入,半年后行Ⅱ期手术,完成种植牙修复。结果:全部病例术后过程顺利,骨肌皮瓣全部成活,下颌骨外形恢复满意。结论:腓骨肌皮瓣可以提供充足的骨组织以及肌肉和皮肤等软组织,适合修复口腔下颌骨复合组织缺损。
Objective:To summarize the experience of using vascularized fibular osteomyocutaneous flaps for reconstruction of oromandibular composite defects. Methods:Segmental mandibular resection and immediate reconstruction by vascularized fibular graft were performed in 15 patients with benign or malignant mandibular tumors,six fibular flaps with skin paddle and nine without skin paddle.There were defects involving the central part of the mandible in 4 patients, defects involving the body and the ascending ramus in 5 patients and segmental body defect in 6 patients. Segmental osteotomies of the fibular flap were performed to restore the angle and anterior contour of the mandible. A through and through defect was reconstructed with double skin island of fibular osteomyocutaneous flap to provide the mucosal lining of the floor of mouth and the skin cover as well as the anterior arch of the mandible.Two osseointegrated implants were placed into the grafted fubular in 1 patient immediately in the reconstruction operation, and the secondary operation was done six month later and the dental rehabilitation was fulfilled.Results:The postoperative course was uneventful and all the fibula flaps were survived well. The mandible contour restoration was satisfactory.Conclusion:Fibula free flaps may offer enough bone and soft tissues to meet the need of oro mandibular reconstruction.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2002年第5期395-397,共3页
Journal of Nanjing Medical University(Natural Sciences)
关键词
下颌骨复合缺损
外科皮瓣
组织移植术
腓骨
mandibular composite defect
surgical flap
tissue transplantation
fibula
