Kanchanarak C, Sittitrai P, Charoensil R
Department of Otolaryngology, Faculty Medicine, Chiang Mai University, Thailand.
J Med Assoc Thai. 1999 Feb;82(2):126-30.
The purpose of this study was to compare the use of the AO reconstruction plate with immediate free vascularized bone graft mandibular reconstruction. From April 1989 to December 1993 we performed 13 cases of mandibular reconstruction. Reconstruction plates were used in 4 and immediate free bone grafts were used in 9 patients. The overall success rate for use of the plate was 2 of 4 (50%). In one of the plate failure patients, the plate was removed eight months postoperatively. She was able to wear a dental prosthesis. Cancer destruction and microvascular anastomosis of the first seven free flaps were performed by one surgical team. Only 4 free flaps were successful (success rate was 44%). We found that the use of AO plate with flap for lateral defect was relatively safe, simple, functional, time-saving, cosmetically acceptable and could be used successfully in post-operative irradiated patients. Success rate of the free flap was better with two surgical teams. The long-term result of the free flap was more reliable than the AO plate.
本研究的目的是比较AO重建钢板与即刻游离血管化骨移植在下颌骨重建中的应用。1989年4月至1993年12月，我们共进行了13例下颌骨重建手术。4例使用了重建钢板，9例使用了即刻游离骨移植。使用钢板的总体成功率为4例中的2例（50%）。在1例钢板失败的患者中，术后8个月取出了钢板。她能够佩戴假牙。前7例游离皮瓣的癌症切除和微血管吻合由一个手术团队完成。只有4例游离皮瓣成功（成功率为44%）。我们发现，AO钢板联合皮瓣用于外侧缺损相对安全、简单、功能良好、节省时间、美容效果可接受，并且可成功用于术后放疗患者。由两个手术团队操作时游离皮瓣的成功率更高。游离皮瓣的长期效果比AO钢板更可靠。
