[血管化骨瓣用于放射性骨坏死术后下颌骨重建]
[Vascularized osseous flaps for mandibular reconstruction after osteoradionecrosis].
作者信息
Girod A, Boulétreau P, Freidel M, Breton P
机构信息
Service de Chirurgie maxillo-faciale, stomatologie et plastique de la face, CH Lyon-Sud, Pierre-Benite.
出版信息
Rev Stomatol Chir Maxillofac. 2004 Nov;105(5):255-68. doi: 10.1016/s0035-1768(04)72324-4.
INTRODUCTION
The reconstruction of mandibular continuity destroyed by osteoradionecrosis can be a difficult task. The aim of this study was to evaluate the reliability and contribution of vascular osseous flaps for mandibular reconstruction after osteoradionecrosis.
MATERIAL AND METHOD
A retrospective study of patients undergoing mandibular reconstruction after osteoradionecrosis between 1989 and 2002 was performed. Twenty-five mandibular reconstructions were performed in 23 patients: 16 fibular free flaps, 5 osteomuscular serrato-costal free flaps, 1 osteocutaneous external brachial free flap, 1 medial femoral condylar free flap and 2 armed pectoralis major pediculed flaps.
RESULTS
We observed two major complications (8%): loss of one fibular flap and one medial femoral condylar free flap. We observed 42% minor complications. Overall quality of life was constantly enhanced.
DISCUSSION
Fibular flap is definitely a good method for immediate or secondary mandibular reconstruction. A serratocostal flap must be considered as an alternative flap when the fibular flap is unavailable.
引言
重建因放射性骨坏死而破坏的下颌骨连续性可能是一项艰巨的任务。本研究的目的是评估血管化骨瓣在下颌骨放射性骨坏死重建中的可靠性和作用。
材料与方法
对1989年至2002年间接受下颌骨放射性骨坏死后重建的患者进行回顾性研究。23例患者共进行了25次下颌骨重建：16例游离腓骨瓣、5例带肌肉的锯肋游离瓣、1例臂外侧皮瓣、1例股骨内侧髁游离瓣和2例带蒂胸大肌瓣。
结果
我们观察到2例主要并发症（8%）：1例腓骨瓣和1例股骨内侧髁游离瓣坏死。我们观察到42%的轻微并发症。总体生活质量持续提高。
讨论
腓骨瓣无疑是即刻或二期下颌骨重建的好方法。当无法使用腓骨瓣时，锯肋瓣可作为替代瓣考虑。
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