腓骨/髂骨瓣手术技术在下颌骨缺损中的应用回顾性研究。

A retrospective study on application of fibula/iliac flap surgical techniques to mandibular defects.

机构信息

Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

出版信息

Sci Rep. 2023 Oct 2;13(1):16505. doi: 10.1038/s41598-023-43643-4.

Abstract

This study group consists of a total of 61 patients who underwent fibula flap and iliac flap surgeries to repair mandibular defects. Patients' Quality Of life (QOL) at 6 and 24 months after surgery is investigated and compared by the EORTC-QLQ-H&N and OHIP-14. The base data of the two groups of patients are collected and analysed by the SPSS 20.0 statistical software. Independent sample t test was conducted for EORTC-QLQ-H&N and OHIP-14 scores at two time points in each group. The 61 cases of free flap all survived and the difference in the location of the primary tumor between the two groups is statistically significant. The EORTC-QLQ-H&N showed that the score of speech, diet, social contact, and teeth all went up at 6 months after surgery, but went down dramatically at 24 months after surgery. The OHIP-14 showed that there was significant reduction in functional limitation at 24 months after surgery, with statistical significance (p < 0.05) between the groups of iliac flap (19.16 ± 5.33) and fibula flap (33.77 ± 7.71). Therefore, it is suggested that patients suffering from mandibular defects receive surgery utilizing the iliac flap, while those with a larger range of defects or lesions involving the condyle and chin should receive corrective surgery utilizing the fibular flap.

摘要

本研究组共纳入 61 例行腓骨瓣和髂骨瓣修复下颌骨缺损的患者。通过 EORTC-QLQ-H&N 和 OHIP-14 调查并比较患者术后 6 个月和 24 个月的生活质量(QOL)。收集并分析两组患者的基本数据,采用 SPSS 20.0 统计软件。对两组患者 EORTC-QLQ-H&N 和 OHIP-14 评分在两个时间点分别进行独立样本 t 检验。61 例游离皮瓣均存活,两组患者原发肿瘤位置差异有统计学意义。EORTC-QLQ-H&N 评分显示,术后 6 个月时,言语、饮食、社会交往和牙齿评分均升高,但术后 24 个月时明显下降。OHIP-14 评分显示,术后 24 个月时,功能障碍显著减少,髂骨瓣组(19.16±5.33)和腓骨瓣组(33.77±7.71)差异有统计学意义(p<0.05)。因此,建议下颌骨缺损患者采用髂骨瓣手术,而对于缺损范围较大或累及髁突和颏部的患者,则应采用腓骨瓣矫正手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e1/10545820/5190a5dd3b26/41598_2023_43643_Fig1_HTML.jpg

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