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采用旋髂深动脉皮瓣进行上颌前部重建的新系列手术设计

New series of surgical design for anterior maxillary reconstruction with deep circumflex iliac artery flap.

作者信息

Jie Bimeng, Lv Xiaoming, Zheng Lei, Zhang Yi, He Yang

机构信息

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Department of Oral and Maxillofacial Surgery, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.

出版信息

Head Neck. 2020 Nov;42(11):3438-3445. doi: 10.1002/hed.26406. Epub 2020 Aug 6.

Abstract

Microsurgical reconstruction for anterior maxillary defects presents a surgical challenge. The objective of this study was to ascertain the feasibility of a new series of intraoral surgical approach using deep circumflex iliac artery (DCIA) flap to achieve functional reconstruction for anterior maxillary defects. Two male patients with anterior maxillary defects (Brown Class IC) were treated in this study. Both patients underwent computer-assisted maxillary reconstruction with a DCIA flap (with pedicle positioning laterally to the bony flap) using intraoral anastomosis techniques. The overall DCIA flap survival rate was 100% and mucosa was all healed uneventfully. One patient received dental implantation and loaded with prosthetic superstructures. Both patients were satisfied with their postoperative oral function and appearance. This study illustrated a new and feasible series of surgical design for anterior maxillary bone defect reconstruction with DCIA flaps and intraoral anastomosis assisted by digital techniques.

摘要

上颌前部缺损的显微外科重建是一项手术挑战。本研究的目的是确定一系列使用旋髂深动脉(DCIA)皮瓣的新型口腔内手术方法用于上颌前部缺损功能重建的可行性。本研究治疗了两名患有上颌前部缺损(Brown I C类)的男性患者。两名患者均采用口腔内吻合技术,使用DCIA皮瓣(蒂位于骨瓣外侧)进行计算机辅助上颌重建。DCIA皮瓣总体存活率为100%,黏膜均顺利愈合。一名患者接受了牙种植并安装了修复上部结构。两名患者对术后口腔功能和外观均满意。本研究阐明了一种新型且可行的手术设计,即采用DCIA皮瓣并借助数字技术辅助进行口腔内吻合,用于上颌前部骨缺损重建。

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