Department of Maxillofacial Surgery, Kanaker-Zeytun Medical Centre, (Head: Aram Kasyan, MD), 7 Nersisyan Str, Yerevan, 0014, Armenia.
Chair of Postgraduate Maxillofacial Surgery, Yerevan State Medical University, (Head: Prof. Yuri Poghosyan DSc), 2 Koryun Str, Yerevan, 0025, Armenia.
J Craniomaxillofac Surg. 2018 May;46(5):831-836. doi: 10.1016/j.jcms.2018.03.007. Epub 2018 Mar 20.
'Krokodil' is the street name of a new synthetic drug mixture. It is a light brown liquid that is used intravenously without previous purification. Osteonecrosis of the jaw (ONJ) is a common complication among Krokodil users. Krokodil drug-related ONJ presents as alveolar process exposure in the oral cavity. Surgery is the main method for treatment of Krokodil drug-related ONJ patients. In a study by Poghosyan et al., no cases of recurrence were seen after surgery on the maxilla, but 38% of cases (8/21) developed an oroantral communication after surgical treatment for maxillary osteonecrosis (Poghosyan et al., 2014). The aim of this study is to report on the results of buccal fat pad use in closure of maxillary sinus floor defects after partial maxillary resection in Krokodil drug-related ONJ patients. Six male patients with Krokodil drug-related distal maxillary osteonecrosis were included in this retrospective study. All patients underwent surgical treatment, which included surgical removal of necrotic bone, and closure of formed maxillary sinus floor defects with buccal fat pad and local mucoperiosteal flaps. In all patients the postoperative period was uneventful. After suture removal small areas of buccal fad pad exposure were found in all patients, which epithelialized successfully over the following month. During the postoperative follow-up period (8-12 months) no signs of recurrence were found.
“Krokodil”是一种新型合成药物混合物的街头名称。它是一种浅棕色的液体，未经预先纯化即进行静脉内使用。颌骨坏死（ONJ）是“Krokodil”使用者的常见并发症。Krokodil 药物相关的 ONJ 表现为口腔内牙槽突暴露。手术是治疗 Krokodil 药物相关 ONJ 患者的主要方法。在 Poghosyan 等人的研究中，上颌骨手术后未见复发病例，但 21 例中 38%（8/21）在接受上颌骨骨坏死手术后发生了口鼻瘘（Poghosyan 等人，2014 年）。本研究旨在报告在 Krokodil 药物相关 ONJ 患者中，使用颊脂垫封闭上颌窦底缺损的结果。本回顾性研究纳入了 6 名男性 Krokodil 药物相关远侧上颌骨坏死患者。所有患者均接受了手术治疗，包括手术切除坏死骨，并使用颊脂垫和局部黏膜骨瓣封闭形成的上颌窦底缺损。所有患者的术后期均无并发症。拆线后，所有患者均发现颊脂垫小块暴露，随后在接下来的一个月内成功上皮化。在术后随访期间（8-12 个月）未发现复发迹象。
