带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网重建上颌骨缺损

华西口腔医学杂志

带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网重建上颌骨缺损

姚金光1;李龙江2;李俊1;陈海波1;罗修汉1

1．右江民族医学院口腔颌面外科学教研室，广西百色 533000
2．四川大学华西口腔医学院口腔颌面外科学教研室，四川成都 610041

收稿日期:2006-02-25 修回日期:2006-02-25 出版日期:2006-02-20 发布日期:2006-02-20
通讯作者: 李龙江, Tel: 028-85501440
作者简介:姚金光（1965-）, 男, 广西人, 副教授, 现为四川大学博士研究生
基金资助:
高等学校博士学科点专项科研基金资助项目（20040610079 ） ?眼作者简介 ?演姚金光（1965-）, 男, 广西人, 副教授, 现为四川大学博
士研究生

Reconstruction of Maxillary Defects Combination with Pedicled Buccal Fat Pad Graft, Temporalis Myofascial Flap and Titanium Mesh

YAO Jin-guang1, LI Long-jiang2, LI Jun1, CHEN Hai-bo1, LUO Xiu-han1

1. Dept. of Oral and Maxillofacial Surgery, Youjiang Medical College for Nationalities, Baise 533000， China; 2. Dept. of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu 610041, China

Received:2006-02-25 Revised:2006-02-25 Online:2006-02-20 Published:2006-02-20

摘要/Abstract

摘要：

目的探讨应用带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网对上颌骨缺损行闭合式三维重建方法的可行性。方法 11例上颌骨肿瘤患者，8例行上颌骨次全切除，其余3例行上颌骨全切除，术中同期应用带蒂颊脂垫衬里和颞肌筋膜瓣联合钛网构筑上颌骨各壁，恢复上颌骨外形。结果所有病例组织瓣全部成活，带蒂颊脂垫瓣和颞肌筋膜瓣术后4—6周上皮化，恢复鼻腔、腭部、牙槽及牙弓外形。张口度2.5—4 cm，进食时无食物从鼻腔返流，发音恢复良好，对面容外形修复效果较满意。3例上颌骨全切除的患者术后随访无复视。结论采用带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网闭合式重建上颌骨缺损的方法，可恢复患者的外形和功能，术式简单适用、风险小。

关键词: 上颌骨缺损, 重建外科手术, 带蒂颊脂垫瓣, 颞肌筋膜瓣, 钛网

Abstract:

Objective To study the feasibility of close and three-dimensional reconstruction of maxillary defects combination with pedicled buccal fat pad graft, temporalis myofascial flap and titanium mesh. Methods Among 11 patients with maxillary tumors, 9 were malignant and 2 were benign. 8 cases underwent subtotal maxillectomy and 3 cases underwent total maxillectomy. Maxillary defects were closely reconstructed combination with pedicled buccal fat pad graft(BFP), temporalis myofascial flap（TMF） and titanium mesh to restore the profile of maxilla. Results All flaps were alive with satisfactory function and aesthetic appearance. The uncovered BFP and the facial muscle surface of TMF epithelialized within 4-6 weeks. Their degree of mouth opening ranged from 2.5 to 4.0 cm and without nasal foods return. All patients had a good voice quality. Conclusion Making use of BFP, TMF and titanium mesh can restore the good contour and function of maxillary． It is an effective method of reconstruction of maxillary defects, and is easy to manipulate. It is worthy to popularization.

Key words: maxillarydefect, reconstructivesurgicalprocedures, pedicledbuccalfatpadgraft, temporalismy-ofascialflap, titaniummesh

姚金光;李龙江;李俊;陈海波;罗修汉. 带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网重建上颌骨缺损[J]. 华西口腔医学杂志.

YAO Jin-guang1, LI Long-jiang2, LI Jun1, CHEN Hai-bo1, LUO Xiu-han1. Reconstruction of Maxillary Defects Combination with Pedicled Buccal Fat Pad Graft, Temporalis Myofascial Flap and Titanium Mesh[J]. West China Journal of Stomatology.

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