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口腔黏膜下纤维化患者手术缺损修复中颊脂垫与改良鼻唇沟皮瓣的临床对比评估

A Comparative Clinical Evaluation of the Buccal Fat Pad and Extended Nasolabial Flap in the Reconstruction of the Surgical Defect in Oral Submucous Fibrosis Patients.

作者信息

Agrawal Deepak, Pathak Richa, Newaskar Vilas, Idrees Faisal, Waskle Rajesh

机构信息

Reader, Department of Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, India.

Dental Surgeon, Department of Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, India.

出版信息

J Oral Maxillofac Surg. 2018 Mar;76(3):676.e1-676.e5. doi: 10.1016/j.joms.2017.11.013. Epub 2017 Nov 21.

Abstract

PURPOSE

The aim of this study was to compare the efficacy of locally available nasolabial and buccal fat pad flaps for increasing postoperative mouth opening in the reconstruction of the defect created after fiberotomy in surgically treated cases of oral submucous fibrosis (OSMF).

MATERIALS AND METHODS

Of 32 patients selected for the study, 21 patients underwent closure of the surgical defect using the buccal fat pad (group 1) and 11 patients underwent closure of the surgical defect using a nasolabial flap (group 2). Histologically proven cases of OSMF with a mouth opening no larger than 25 mm were included in the study. Patients in groups 1 and 2 were evaluated at regular intervals and mouth opening was documented preoperatively, intraoperatively, and at 3 and 6 months of follow-up. The results were analyzed by paired and unpaired t tests.

RESULTS

In groups 1 and 2, mouth opening differed substantially at all periods of follow-up from preoperative values. At 3-month follow-up, mean mouth opening increased to 32.41 mm in group 2 compared with 30.47 in group 1. No relevant difference was observed in mouth opening between groups 1 and 2 at the end of 6 months. The effective increase in mouth opening at the end of 6 months compared with the preoperative value was statistically different in group 2 (mean increase, 24.2 mm) compared with group 1 (mean increase, 19.2 mm).

CONCLUSION

Nasolabial flaps are a good option for the coverage of surgically treated defects in OSMF compared with the buccal fat pad.

摘要

目的

本研究旨在比较在口腔黏膜下纤维化(OSMF)手术治疗病例中,局部可用的鼻唇沟脂肪垫瓣和颊脂垫瓣在增加术后开口度方面的疗效,这些病例在纤维切断术后进行缺损修复。

材料与方法

在入选本研究的32例患者中,21例患者使用颊脂垫关闭手术缺损(第1组),11例患者使用鼻唇沟瓣关闭手术缺损(第2组)。组织学确诊且开口度不超过25毫米的OSMF病例纳入本研究。第1组和第2组患者定期接受评估,并记录术前、术中以及随访3个月和6个月时的开口度。结果采用配对和非配对t检验进行分析。

结果

在第1组和第2组中,随访各阶段的开口度与术前值相比均有显著差异。在3个月随访时,第2组的平均开口度增加到32.41毫米,而第1组为30.47毫米。在6个月末,第1组和第2组之间的开口度未观察到相关差异。与术前值相比,第2组在6个月末开口度的有效增加(平均增加24.2毫米)与第1组(平均增加19.2毫米)相比有统计学差异。

结论

与颊脂垫相比,鼻唇沟瓣是覆盖OSMF手术治疗缺损的良好选择。

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