Yang Sunin, Jee Yu-Jin, Ryu Dong-Mok
Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Kyung Hee University, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea.
Maxillofac Plast Reconstr Surg. 2018 Apr 5;40(1):7. doi: 10.1186/s40902-018-0144-6. eCollection 2018 Dec.
Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction.
This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort.
In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.
上颌窦口腔交通性缺损,其特征为上颌窦与口腔之间存在连接,常由拔牙、囊肿及良性肿瘤切除以及恶性肿瘤切除引起。手术缺损可能发展为上颌窦口腔瘘,导致患者不适和慢性上颌窦炎。小的缺损可能会自行闭合;然而,大的上颌窦口腔缺损通常需要重建。这些大的缺损可以用皮肤移植和带血管游离皮瓣进行重建,可带或不带骨移植。然而,此类手术技术复杂且难度较大。颊脂垫是一种用于重建的有效、可靠且简便的材料。
本报告描述了三例大的上颌窦口腔缺损重建病例,所有病例均采用带蒂颊脂垫覆盖。随访摄影和影像学检查显示上颌窦口腔缺损成功闭合。此外,没有手术部位并发症,也没有患者报告术后不适。
总之,使用带蒂颊脂垫是一种可靠、安全且成功的大的上颌窦口腔缺损重建方法。