Bremerhaven and Hamburg, Germany; and Tehran, Iran From the Department of Oral and Maxillofacial Surgery, Bremerhaven Hospital (Reinkenheide); the Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf; the Craniofacial Research Center and Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences; and the Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, and the Craniomaxillofacial Research Center, Tehran University of Medical Science.
Plast Reconstr Surg. 2013 Sep;132(3):413e-427e. doi: 10.1097/PRS.0b013e31829ad0d9.
Alloplastic mandibular reconstruction remains insufficiently predictable, with no systematic reviews to assess its scope and limitations.
The PubMed, CINAHL, EMBASE, and Web of Science databases were searched for English study reports, published in the current century, of mere alloplastic surgical reconstruction of mandibular ablative defects.
In 14 articles, there were 944 patients, with a median age of 58.7 years (interquartile range, 53.2 to 62 years); 58.7 percent (interquartile range, 66.7 to 78.6 percent) were male. Cases of squamous cell carcinoma per study constituted 93.5 percent (interquartile range, 81.5 to 100 percent). Defects were mostly lateral (Boyd classification) (60.5 percent; interquartile range, 56.2 to 62 percent) and received mostly conventional bridging plates (in 64.3 percent of the studies) and pedicled flaps (45.3 percent; interquartile range, 37.1 to 58.3 percent); 60.7 percent (interquartile range, 53.5 to 58.8 percent) received adjuvant therapy. At 32-month follow-up, the complication and failure rates were 40.1 percent (interquartile range, 26.7 to 58.6 percent) and 30.8 percent (interquartile range, 11.7 to 48.1 percent), respectively. The overall survival rate was 55 percent (interquartile range, 27.8 to 74 percent). Radiotherapy seemed to be a relative risk factor for complications (1.387; p = 0.014) and plate loss (1.585; p = 0.006). Crossing the midline seemed to be a relative risk factor for plate exposure (1.533; p = 0.000) and overall complications (1.385; p = 0.002).
The results should be generalized cautiously. Alloplastic reconstructive surgery faces a remarkable lack of evidence. Relatively high complication and failure rates are areas of further concern.
异体下颌骨重建仍然不够预测，没有系统评价来评估其范围和局限性。
检索了 PubMed、CINAHL、EMBASE 和 Web of Science 数据库，以获取本世纪发表的仅涉及异体外科重建下颌切除缺损的英文研究报告。
在 14 篇文章中，有 944 例患者，中位年龄为 58.7 岁（四分位间距，53.2 至 62 岁）；58.7%（四分位间距，66.7 至 78.6%）为男性。每项研究中的鳞状细胞癌病例占 93.5%（四分位间距，81.5%至 100%）。缺损主要为外侧（Boyd 分类）（60.5%；四分位间距，56.2%至 62%），主要采用常规桥接板（64.3%的研究）和带蒂皮瓣（45.3%；四分位间距，37.1%至 58.3%）；60.7%（四分位间距，53.5%至 58.8%）接受辅助治疗。在 32 个月的随访中，并发症和失败率分别为 40.1%（四分位间距，26.7%至 58.6%）和 30.8%（四分位间距，11.7%至 48.1%）。总体生存率为 55%（四分位间距，27.8%至 74%）。放疗似乎是并发症（1.387；p=0.014）和钢板丢失（1.585；p=0.006）的相对风险因素。跨中线似乎是钢板外露（1.533；p=0.000）和总体并发症（1.385；p=0.002）的相对风险因素。
结果应谨慎推广。异体重建手术面临着明显缺乏证据的问题。相对较高的并发症和失败率是进一步关注的领域。
