Butsan S B, Gileva K S, Verbo E V, Khokhlachev S B, Abramian S V, Smal A A, Bulat S G
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
Stomatologiia (Mosk). 2018;97(3):35-43. doi: 10.17116/stomat201897335.
One of the most important steps in achieving aesthetical and functional result in mandible reconstruction with fibula free flap is positioning of the bony part relative to the basis of the native mandible. Positioning fibular bony part continuing inferior mandible border may produce a high discrepancy between the residual mandible and fibula bone that results in difficulty in denture rehabilitation. Positioning fibular bony part continuing alveolar mandible border creates asymmetric jowls and changed shape of jawline in border-line zone. The double-barrel technique solves this problem, but needs a meticulous preoperative planning and precision free fibula flap modelling.
在采用游离腓骨瓣进行下颌骨重建以获得美学和功能效果的过程中,最重要的步骤之一是将骨部分相对于天然下颌骨的基部进行定位。将腓骨骨部分定位为延续下颌骨下缘可能会导致残余下颌骨与腓骨之间存在较大差异,从而导致义齿修复困难。将腓骨骨部分定位为延续下颌牙槽缘会在边界区域产生不对称的脸颊赘肉并改变下颌轮廓形状。双管技术解决了这个问题,但需要细致的术前规划和精确的游离腓骨瓣塑形。