Sönmez Erhan, Tözüm Tolga Fikret, Tulunoglu Ibrahim, Sönmez Nalan Sule, Safak Tunc
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Ann Plast Surg. 2012 Nov;69(5):529-34. doi: 10.1097/SAP.0b013e31821d06f3.
Ablative surgeries for neoplastic processes of the oral cavity, traumas, infections/inflammations, osteoradionecrosis, and congenital deformities are the most common causes of large mandibular defects. Ameloblastoma is a locally aggressive tumor that, if not treated, can gain an enormous size and cause severe facial disfigurement and functional impairment. Although the smaller lesions of ameloblastoma in the mandible are treated by conservative approaches such as marsupialization, enucleation, and curettage combined with liquid nitrogen spray cryosurgery, larger lesions require radical surgical ablation procedures resulting in large tissue defects. A large mandibular defect has deleterious effects on a person's life, with a significant loss in the quality of life unless it is reconstructed successfully. The aim of present case series report is to show the results of the multidisciplinary treatment of patients with advanced stage ameloblastoma, including tumor resection, simultaneous reconstruction with iliac crest flap, followed by placement of endosseous dental implants, and finally the prosthodontic rehabilitation.
口腔肿瘤病变、创伤、感染/炎症、放射性骨坏死和先天性畸形的切除手术是导致下颌骨大面积缺损的最常见原因。成釉细胞瘤是一种具有局部侵袭性的肿瘤,如果不进行治疗,其体积会变得巨大,导致严重的面部畸形和功能障碍。虽然下颌骨较小的成釉细胞瘤病变可通过袋形缝合术、摘除术、刮除术结合液氮喷雾冷冻手术等保守方法治疗,但较大的病变则需要进行根治性手术切除,从而导致大面积组织缺损。下颌骨大面积缺损会对患者的生活产生有害影响,除非成功重建,否则患者的生活质量会大幅下降。本病例系列报告的目的是展示晚期成釉细胞瘤患者多学科治疗的结果,包括肿瘤切除、同时使用髂嵴皮瓣进行重建、随后植入骨内牙种植体,最后进行义齿修复。