Department of Plastic and Reconstructive Surgery, and Department of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Head Neck. 2012 Mar;34(3):384-92. doi: 10.1002/hed.21740. Epub 2011 May 16.
This study presents an alternative in reconstruction, using free skin flaps in combination with pedicled mandible bone flaps for complex lateral mandibular defects.
In all, 13 patients were included in this prospective study. Pedicled mandible myo-osseous flaps were used for reconstruction of bone defects of the lateral mandible in combination with free skin flaps, including radial forearm flaps (n = 3), anterolateral thigh (ALT) flaps (n = 9), and local tongue flap (n = 1). Postoperatively, a (99m)Tc-methyl diphosphonate bone scan was performed to assess bone flap viability.
All patients had acceptably contoured mandibles. The major complications consisted of 1 failed ALT flap and 2 nonviable bone flaps. The bone scan confirmed viable bone flaps in 11 cases. Ten patients (77%) were able to resume soft to full diets.
For complex lateral mandibular defects (≤6 cm), a combination of the pedicled mandible myo-osseous flaps and free skin flaps is an alternative in reconstruction.
本研究提出了一种替代方法，即使用游离皮瓣联合带蒂下颌骨骨瓣来修复复杂的下颌外侧骨缺损。
本前瞻性研究共纳入 13 例患者。带蒂下颌骨肌骨瓣用于修复下颌外侧骨缺损，同时使用游离皮瓣，包括前臂桡侧游离皮瓣（n = 3）、股前外侧游离皮瓣（n = 9）和局部舌瓣（n = 1）。术后，进行（99m）Tc-亚甲基二膦酸盐骨扫描以评估骨瓣的活力。
所有患者的下颌外形均令人满意。主要并发症包括 1 例 ALT 皮瓣失败和 2 例骨瓣无活力。骨扫描证实 11 例骨瓣有活力。10 例患者（77%）能够恢复软食至全食。
对于复杂的下颌外侧骨缺损（≤6cm），带蒂下颌骨肌骨瓣联合游离皮瓣是一种替代的重建方法。
