González García Raúl, Rodríguez Campo Francisco J, Naval Gías Luis, Muñoz Guerra Mario F, Sastre Pérez Jesús, Díaz González Francisco J
Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Madrid, Spain.
Med Oral Patol Oral Cir Bucal. 2006 Nov 1;11(6):E531-5.
The odontogenic myxoma is a rare entity located in mandible and upper maxilla. Due to its local aggressiveness, wide surgical excision is mandatory. Several surgical techniques have been described for the reconstruction of segmental mandibular defects. In comparison with other free flaps, the vascularized free fibular flap (VFFF) supports the longest amount of bone and, due to the nature of the vascular supply a complete freedom in location of the osteotomy is present. A precise mandibular arc can be performed following bone resection. We suggest the performance of the in situ VFFF technique in order to recreate mandibular contour by means of several osteotomies, while the pedicle is still attached to the leg. Substantial decrease in surgical time is obtained. With the double-barrel technique and subsequent osseointegrated implants, good results are obtained in the reconstruction of dentate patients without maxillary atrophy. We present two new cases of large odontogenic mandibular myxoma. Wide surgical excision by means of hemimandibulectomies and subsequent reconstruction with VFFF were performed.
牙源性黏液瘤是一种罕见的病变，位于下颌骨和上颌骨。由于其局部侵袭性，必须进行广泛的手术切除。已经描述了几种用于重建节段性下颌骨缺损的手术技术。与其他游离皮瓣相比，带血管蒂游离腓骨瓣（VFFF）能提供最长的骨量，并且由于血管供应的性质，截骨位置具有完全的自由度。骨切除后可以进行精确的下颌骨弧度塑形。我们建议采用原位VFFF技术，通过多次截骨来重塑下颌轮廓，同时蒂仍附着于腿部。这样可大幅缩短手术时间。采用双筒技术及后续的骨整合种植体，在无上颌萎缩的牙列患者重建中可取得良好效果。我们报告两例大型牙源性下颌黏液瘤的新病例。通过半侧下颌骨切除术进行广泛的手术切除，随后用VFFF进行重建。
