University Hospital Giessen, Dept. for Maxillofacial Surgery, (Head: Prof. Dr. Hans-Peter Howaldt), Klinikstr. 33, 35392, Giessen, Germany.
University Hospital Kiel, Dept. for Maxillofacial Surgery, (Head: Prof. Dr. Joerg Wiltfang), Arnold-Heller-Straße 16, 24105, Kiel, Germany.
J Craniomaxillofac Surg. 2019 May;47(5):786-791. doi: 10.1016/j.jcms.2018.12.017. Epub 2019 Jan 3.
Microvascular fibula flap surgery is a reliable and effective procedure for reconstructing the jaws after tumour surgery. This procedure allows the placement of dental implants after bone consolidation. This study was designed to evaluate the oral, functional, and aesthetic rehabilitation of tumour patients with immediate fibula transfer and dental implants and included assessment of diet, speech, and aesthetics.
The study included 34 patients who underwent ablative tumour surgery and immediate jaw reconstruction using a fibula free flap with consecutive rehabilitation by dental implants. In total, 134 implants were inserted into the transferred fibula. The functional and aesthetic results were assessed using a questionnaire. Implant loss and oral excursion were compared with diet type, speech ability, functionality, and patient satisfaction.
Of the 34 patients included in this study, 33 completed the questionnaire. Twenty-six patients (76%) could eat normally without the limitation of a hard or soft diet, 73% could speak intelligibly, and 31 rated the aesthetic result from good to excellent.
The fibula flap with the early application of endosseous implants allowed primary immediate reconstruction of the jaw, significantly leading to functional and aesthetic satisfaction in patients who underwent ablative tumour surgery.
微血管腓骨皮瓣手术是一种可靠且有效的方法，可用于重建肿瘤手术后的颌骨。该手术允许在骨整合后放置牙种植体。本研究旨在评估即刻腓骨转移和牙种植体对肿瘤患者的口腔、功能和美学康复的影响，并评估饮食、言语和美学。
该研究纳入了 34 名接受肿瘤切除术和游离腓骨即刻下颌骨重建的患者，随后进行牙种植体连续修复。总共将 134 个种植体植入转移的腓骨中。使用问卷调查评估功能和美学结果。比较了种植体丢失和口腔运动与饮食类型、言语能力、功能和患者满意度的关系。
本研究共纳入 34 名患者，其中 33 名完成了问卷调查。26 名患者（76%）可以正常进食，不受软、硬饮食的限制，73%的患者言语清晰，31%的患者对美学效果评价良好至优秀。
游离腓骨皮瓣早期应用骨内种植体可实现颌骨的即刻重建，显著提高肿瘤切除术患者的功能和美学满意度。
