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采用双侧游离腓骨瓣进行颌骨缺损重建并植入牙种植体及即刻负重:三团队协作方法的病例报告

Maxillo-mandibular Defect Reconstruction with Bilateral Free Fibula Flaps with Dental Implant Placement and Immediate Loading: A Case Report of the Three-team Approach.

作者信息

Nazarian David, Dikarev Aleksei, Mokhirev Mikhail, Zakharov Georgy, Fedosov Alexander, Potapov Maksim, Chernenkiy Mikhail, Vasilev Yuriy, Kyalov Grigoriy, Chausheva Saniyat, Khachatryan Arbak, Tevosyan Artur, Arakelyan Gevorg

机构信息

Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia.

Maxillofacial and Reconstructive Surgery Department, NK Clinic, Moscow, Russia.

出版信息

Arch Plast Surg. 2022 Sep 23;49(5):652-655. doi: 10.1055/s-0042-1756350. eCollection 2022 Sep.

Abstract

Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

摘要

对于头颈外科医生来说,治疗包括上下颌骨在内的晚期恶性肿瘤患者是一项具有挑战性的任务。目前的治疗情况表明,对于以前只能接受姑息治疗的患者,现在能取得良好的功能、解剖和美学效果。头颈部肿瘤切除导致的广泛组织缺损,由于重要结构暴露且与外部环境接触,需要立即进行重建。一名患者接受了三团队多学科手术,包括颌面及重建显微外科的三个专业团队、一名种植专家和一名修复牙医同时开展工作。这种方法允许在切除肿瘤的同时,对术中缺损进行后续重建,包括双侧切取两块带血管蒂的游离腓骨骨肌皮瓣并植入牙齿,以及同时用牙冠修复牙列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef21/9507612/eea841a67a6f/10-1055-s-0042-1756350-i21307-1.jpg

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