Lambertsen Karin, Bundgaard Troels
Øre-naese-halskirurgisk Afdeling H, Arhus Universitetshospital, Arhus Sygehus, DK-8000 Arhus C.
Ugeskr Laeger. 2009 Aug 17;171(34):2391-5.
Removal of the maxilla requires adequate restoration of the maxillary structure to replace form and functions, especially vocal and eating functions. A host of reconstructive options are available to restore the maxilla, most of which include free-flap reconstruction. The aim of this study was to clinically evaluate the use of pedicled temporalis flap for reconstruction of the maxilla and to assess patient quality of life.
In the period 2000-2007, a total of 32 patients with malignant tumours of the maxilla were operated with immediate reconstruction of the maxilla using pedicle temporalis muscle flap at the ENT department, Aarhus University Hospital. Follow-up was implemented in 2007. Twenty-seven of 28 patients alive at the time of the follow-up participated in the study. The patients were evaluated objectively as well as subjectively by answering the EORTC's standard questionnaire concerning quality of life and functional results.
Few patients had complaints and these where mostly minor functional deficits. The most common complaints were slightly impaired mouth opening. One temporalis muscle flap necrotized and was removed. Three patients developed oro-nasal/antral fistula, witch were later closed using local flaps.
The follow-up study of the 27 patients showed a most satisfactory result evaluated objectively as well as subjectively using the EORTC questionnaire.
上颌骨切除术后需要对上颌骨结构进行充分修复,以恢复其形态和功能,尤其是发声和进食功能。目前有多种重建方法可用于上颌骨修复,其中大多数包括游离皮瓣重建。本研究的目的是临床评估带蒂颞肌瓣在上颌骨重建中的应用,并评估患者的生活质量。
2000年至2007年期间,奥胡斯大学医院耳鼻喉科对32例上颌骨恶性肿瘤患者采用带蒂颞肌瓣立即进行上颌骨重建手术。2007年进行随访。随访时存活的28例患者中有27例参与了研究。通过回答欧洲癌症研究与治疗组织(EORTC)关于生活质量和功能结果的标准问卷,对患者进行客观和主观评估。
很少有患者有不适主诉,且大多为轻微功能缺陷。最常见的主诉是张口轻度受限。一块颞肌瓣坏死并被切除。3例患者出现口鼻/鼻窦瘘,后来采用局部皮瓣封闭。
对27例患者的随访研究表明,使用EORTC问卷进行客观和主观评估,结果非常令人满意。