Zimmermann C E, Börner B I, Hasse A, Sieg P
Department of Maxillofacial Surgery, University Hospital of Lübeck, Germany.
Clin Oral Investig. 2001 Dec;5(4):214-9. doi: 10.1007/s00784-001-0140-5.
The free microvascular fibula and soft tissue transfer has become a widely used method to reconstruct the head and neck region. Only few reports focus on the donor site morbidity of purely mandibular reconstructions. On the basis of the hospital charts, a standardized patient interview and a standardized physical examination, the present study evaluates the early and late donor site morbidity in 42 mostly oncologic patients after an average follow-up interval of 34 months. Of these, 16 patients (38.1%) exhibited complicated wound healing that did not correlate with the patient's age, sex, type of transplant, use of a skin graft, result of preoperative angiography, rate of postoperative mobilization or the incidence of late donor site morbidity. At the time of follow-up examination, about one-fourth of the patients reported discomfort, pain or swelling. Objective findings included sensory deficits in 76.3%, motor deficits in 39.5% and reduced strength in 44.7% of the patients. Even though objectively measured morbidity exceeded subjectively perceived morbidity, it can be concluded that there is significant early and late donor site morbidity, which should be considered when opting for a fibula graft. Patients should be informed accordingly.
游离微血管腓骨及软组织移植已成为重建头颈部的一种广泛应用的方法。仅有少数报告关注单纯下颌骨重建的供区并发症。基于医院病历、标准化的患者访谈及标准化体格检查，本研究评估了42例主要为肿瘤患者在平均34个月的随访期后的早期及晚期供区并发症。其中，16例患者（38.1%）出现复杂的伤口愈合情况，这与患者的年龄、性别、移植类型、是否使用皮肤移植、术前血管造影结果、术后活动率或晚期供区并发症发生率无关。在随访检查时，约四分之一的患者报告有不适、疼痛或肿胀。客观检查结果包括76.3%的患者有感觉障碍，39.5%的患者有运动障碍，44.7%的患者力量减弱。尽管客观测量的并发症超过了主观感知的并发症，但可以得出结论，存在显著的早期和晚期供区并发症，在选择腓骨移植时应予以考虑。应相应地告知患者。
