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对于口腔黏膜下纤维化患者,在手术松解纤维条索后,颊脂垫用于修复口腔内缺损是否比鼻唇沟瓣更好?一项初步研究:口腔黏膜下纤维化的治疗方案。

Is buccal fat pad a better option than nasolabial flap for reconstruction of intraoral defects after surgical release of fibrous bands in patients with oral submucous fibrosis? A pilot study: a protocol for the management of oral submucous fibrosis.

作者信息

Rai Anshul, Datarkar Abhay, Rai Monika

机构信息

Department of Trauma and Emergency Medicine, AIIMS, Bhopal, M.P., India.

Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, M.H., India.

出版信息

J Craniomaxillofac Surg. 2014 Jul;42(5):e111-6. doi: 10.1016/j.jcms.2013.07.006. Epub 2013 Oct 6.

Abstract

PURPOSE

The aim this study was to compare the buccal fat pad (BFP) and nasolabial flap for reconstruction of intraoral defects after release of fibrous bands in patients with oral submucous fibrosis (OSF).

MATERIALS AND METHODS

This is a comparative study. The study sample was derived from the population of patients who presented, with restricted mouth opening of less than 20 mm, to the Department of Oral and Maxillofacial Surgery, Swargiya Dada Saheb Kalmegh Dental College and Hospital Hingna Nagpur. The patients were divided into two groups. In Group I (n = 10) reconstruction was performed with a nasolabial flap and in Group II (n = 10) with BFP. Both groups were analysed separately for mouth opening (interincisal distance in millimetres) preoperatively and 20 months postoperatively, time taken for epithelialization of BFP and nasolabial flaps. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Inc, Chicago, IL) using the _2 test and Student's t test.

RESULTS

In all 20 patients the interincisal mouth opening was (mean) 11 mm (3-19 mm) preoperatively which improved to a mean of 42 mm (23-52 mm). In Group I there were more complications as compared to Group II such as partial flap necrosis particularly at the tips, temporary widening of oral commissure and subluxation of TMJ. The unsightly extraoral scar and intraoral growth of hairs were not seen in Group II.

CONCLUSION

BFP is the better choice for reconstruction in comparison to nasolabial flap.

摘要

目的

本研究旨在比较口腔黏膜下纤维化(OSF)患者在松解纤维条索后,颊脂垫(BFP)和鼻唇沟瓣用于口腔内缺损修复的效果。

材料与方法

这是一项对比研究。研究样本来自斯瓦吉亚·达达·萨赫布·卡尔梅格牙科学院及医院(位于那格浦尔欣格纳)口腔颌面外科,纳入开口受限小于20毫米的患者。患者分为两组。第一组(n = 10)采用鼻唇沟瓣修复,第二组(n = 10)采用颊脂垫修复。分别分析两组患者术前及术后20个月的开口度(切牙间距离,单位为毫米)、颊脂垫和鼻唇沟瓣的上皮化时间。使用Windows版SPSS统计软件(版本8.0,SPSS公司,伊利诺伊州芝加哥)进行统计学分析,采用卡方检验和学生t检验。

结果

所有20例患者术前切牙间开口度平均为11毫米(3 - 19毫米),术后改善至平均42毫米(23 - 52毫米)。与第二组相比,第一组出现更多并发症,如部分瓣坏死,尤其是瓣尖坏死、口角暂时增宽和颞下颌关节半脱位。第二组未见难看的口外瘢痕和口内毛发增生。

结论

与鼻唇沟瓣相比,颊脂垫是更好的修复选择。

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