Wang W, Xu B, Zhu J, Yang C, Shen S, Qian Y
No. 1088 Mid Hai Yuan Road Gaoxin District, Kunming Yunnan 650106, China,
Med Oral Patol Oral Cir Bucal. 2018 Sep 1;23(5):e619-e624. doi: 10.4317/medoral.22505.
Maxillary reconstruction using various pedicled and free-tissue transfer techniques with bone graft or without bone graft has some drawbacks. In this study, we demonstrate maxillary reconstruction using femoris rectus muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle through the modified lateral lip-submandibular approach.
Nine patients suffering from maxillary defects secondary to maxillary cancer ablation, who underwent maxillary reconstruction using rectus femoris muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle, were enrolled into this study between November 2015 and August 2017.
All patients who underwent the maxillary reconstruction using femoris rectus muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle presented satisfactory postoperative function, with adequate mouth opening, optimal esthetic outcome and no restrictions on the diet. Every rectus femoris muscle flaps mucosalized well within five weeks. No donor site functional impairment or complications were observed.
The technique is a feasible and acceptable technique for the maxillary reconstructions. It is safe, quick and simple to harvest. It also presents an optimal esthetic and satisfactory functional outcome with the advantage of low morbidity of the donor site. Combined with the three-dimension reconstruction, this technique can improve the postoperative outcomes.
采用各种带蒂和游离组织移植技术并辅以或不辅以骨移植进行上颌骨重建存在一些缺点。在本研究中,我们展示了通过改良的外侧唇 - 下颌下入路,使用股直肌肌瓣和由颞肌带蒂的下颌支矢状突/冠突移植体进行上颌骨重建。
2015年11月至2017年8月期间,纳入9例因上颌骨癌切除继发上颌骨缺损的患者,他们接受了使用股直肌肌瓣和由颞肌带蒂的下颌支矢状突/冠突移植体进行的上颌骨重建。
所有接受使用股直肌肌瓣和由颞肌带蒂的下颌支矢状突/冠突移植体进行上颌骨重建的患者术后功能均令人满意,张口度足够,美学效果佳,饮食无限制。每块股直肌肌瓣均在五周内良好黏膜化。未观察到供区功能受损或并发症。
该技术是一种可行且可接受的上颌骨重建技术。取材安全、快速且简单。它还呈现出最佳的美学和令人满意的功能效果,且供区发病率低。结合三维重建,该技术可改善术后效果。