Liu Y-M, Chen G-F, Yan J-L, Zhao S-F, Zhang W-M, Zhao S, Chen L
Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Rd. Jiefang 88, Hangzhou 310009, China.
Int J Oral Maxillofac Surg. 2006 Dec;35(12):1108-13. doi: 10.1016/j.ijom.2006.09.012. Epub 2006 Nov 9.
The aim of this study was to evaluate the use of pedicled buccal fat pad flap (PBFPF), prefabricated titanium mesh and autologous bone graft in maxillary reconstruction. Seventeen patients with a unilateral class I-III maxillary defect were involved. Preoperatively, a solid model was manufactured based on virtual maxillectomy and reconstruction of the abnormal maxilla. Intraoperatively, PBFPF was applied to repair the soft-tissue defect, serving as nasal lining and the receiving bed for bone grafts. Titanium mesh was prefabricated on the solid model and then, together with bone grafts from iliac crest, fixed to residual bones to reconstruct the hard-tissue defect. Postoperative aesthetic appearance and function were followed up. No exposure of titanium mesh, leakage or oronasal regurgitation occurred. Of the patients with a class I or II defect 91% (10/11) and of those with a class III defect 50% (3/6) gained a good appearance. Fifteen patients were articulate. Eleven patients received dental rehabilitation and had a normal diet. PBFPF with prefabricated titanium mesh and autologous bone grafts is a reliable option for reconstruction of unilateral maxillary defects of class I and II, but this method alone should be used cautiously in defects of class III and beyond.
本研究的目的是评估带蒂颊脂垫瓣（PBFPF）、预制钛网和自体骨移植在上颌骨重建中的应用。纳入了17例单侧I - III类上颌骨缺损患者。术前，基于虚拟上颌骨切除和异常上颌骨重建制作实体模型。术中，应用PBFPF修复软组织缺损，作为鼻内衬和骨移植的受区。在实体模型上预制钛网，然后与取自髂嵴的骨移植一起固定于残留骨上，以重建硬组织缺损。对术后美观外观和功能进行随访。未发生钛网外露、渗漏或口鼻反流。I类或II类缺损患者中91%（10/11）外观良好，III类缺损患者中50%（3/6）外观良好。15例患者发音清晰。11例患者接受了牙修复且饮食正常。带蒂颊脂垫瓣联合预制钛网和自体骨移植是I类和II类单侧上颌骨缺损重建的可靠选择，但单独使用这种方法治疗III类及以上缺损时应谨慎。
