摘要
目的 评价小腿外侧复合组织瓣移植修复口腔颌面肿瘤切除后缺损的临床应用价值。 方法 1999年 11月～ 2 0 0 2年 12月 ,对 2 8例口腔颌面部肿瘤患者术后应用小腿外侧复合组织瓣游离移植 ,修复骨及软组织缺损。手术采用血管吻合、单叶皮瓣和坚固内固定等恢复口腔颌面缺损器官的形态及完整性。其中 2 1例为带腓骨的腓骨皮瓣移植 ,7例为携带肌肉的腓骨肌皮瓣移植。采用游离小腿外侧皮瓣 ,大小 3.0 cm× 5 .5 cm～ 8.0 cm× 12 .0 cm,腓骨长度 5 .5～ 16 .0 cm。有 3例同期植入种植体共 5枚。 结果 术后 2 4例成功 ,3例部分皮瓣坏死 ,1例肌皮瓣坏死。 3例同期植入的 5枚种植体均达到良好的骨整合效果 ,并已行上部义齿修复。 2 6例获随访 1～ 36个月 ,平均 18.5个月 ,2 3例患者面部外形恢复、张闭口及语音功能达到满意或较满意。 结论 小腿外侧复合组织瓣有充足的可供取用的组织量 ,尤其是对同时伴有大量骨缺损患者。且具备血管蒂长、管径粗、易于吻合 ,以及供区隐蔽等优点 。
Objective To evaluate the advantages and disadvantages of vascularized free peroneal composite flaps for reconstruction of oral and maxillofacial defects. Methods From November 1999 to December 2002, 28 cases of oral maxillofacial defects were reconstructed with vascularized free peroneal composite flaps, with fibula cutaneous flap in 21 cases and with fibula myocutaneous flap in 7 cases. Three cases received insertion of dental implants into the fibula flap. The flap size was 3.0 cm×5.5 cm to 8 0 cm ×12 0 cm; the fibula length was 5.5 cm to 16 0 cm. Results Of the 28 flaps reconstructed, 24 survived, 3 necrosed partially and 1 necrosed completely. All the 5 implants survived and achieved good bone integration in 3 cases. Twenty six cases were followed up 1 36 months with an average of 18.5 months, the facial appearance and the vocal function were satisfactory in 23 cases. Conclusion Vascularized peroneal flap has many advantages and is one of the optimal flaps for reconstruction of oral maxillofacial defects.
出处
《中国修复重建外科杂志》
CAS
CSCD
2004年第4期298-300,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
复合组织瓣
肿瘤
颌面器官缺损
修复重建
Composite tissue flap Tumor Oral maxillofacial defect Repair and reconstruction
