Hao S P
Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan, ROC.
Otolaryngol Head Neck Surg. 2001 Mar;124(3):292-6. doi: 10.1067/mhn.2001.112308.
A retrospective review of 56 patients who were operated through a facial translocation approach was carried out to assess the viability of the translocated facial bone segment.
Eleven patients had preoperative radiotherapy, and 26 had postoperative radiotherapy. In 14 patients the translocated bone segment was kept attached to the anterior cheek, and in 42 patients the bone segment was detached and then implanted. A vascularized flap was used to obliterate the defect in the paranasal sinuses in 15 patients.
Twelve (21.4%) patients had devitalized bone segment and required sequestrectomy. The incidence of devitalized bone segment was higher in the patients who received postoperative radiotherapy (P = 0.04) and lower in the patients in whom the defect in the paranasal sinuses was reconstructed with a vascularized flap (P = 0.006).
The translocated facial bone segment should be kept attached to the cheek soft tissue when possible, or the defect in the paranasal sinuses should be reconstructed with a vascularized flap.
对56例采用面部移位手术入路的患者进行回顾性研究，以评估移位面部骨段的存活情况。
11例患者术前行放疗，26例患者术后行放疗。14例患者的移位骨段与前颊部相连，42例患者的骨段分离后再植入。15例患者采用带血管蒂皮瓣修复鼻窦缺损。
12例（21.4%）患者的骨段出现坏死，需要行死骨切除术。术后放疗患者的骨段坏死发生率较高（P = 0.04），而采用带血管蒂皮瓣修复鼻窦缺损的患者骨段坏死发生率较低（P = 0.006）。
移位面部骨段应尽可能与颊部软组织相连，或采用带血管蒂皮瓣修复鼻窦缺损。
