Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology ＆ National Center for Stomatology ＆ National Clinical Research Center for Oral Diseases ＆National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology ＆ National Center for Stomatology ＆ National Clinical Research Center for Oral Diseases ＆National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China.
Oral Oncol. 2024 Jul;154:106860. doi: 10.1016/j.oraloncology.2024.106860. Epub 2024 May 26.
The deep circumflex iliac artery flap (DCIA) and vascularized fibular free flap (FFF) are mainstay flaps for maxillary defect reconstruction. This study compared the functional outcomes and success rates of these flaps to provide midface reconstruction strategies.
Maxillary defects reconstructed with DCIA or FFF at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology between May 2016 and May 2023 were retrospectively analyzed. The length, width, and height of the grafted bone segments; intermaxillary distance; buttress reconstruction rate (BRR); dental arch reconstruction rate (DAR); success rate; and dental implantation rate were compared.
The DCIA and FFF groups had 33 and 27 patients, respectively. Success rate in the DCIA group was 93.94 % and 100 % in the FFF group. The DCIA length was less than that of FFF; however, the width and height were significantly larger. 87.10 % of cases in the DCIA group were classified as Brown class b and c, 51.85 % of cases in the FFF group were classified as Brown class d. The average BRR in the DCIA group was 69.89 % ± 16.05 %, which was significantly higher than that in the FFF group. A total of 38.7 % and 11.1 % patients in the DCIA and FFF groups, respectively, had completed implantation.
DCIA has a greater width and height, and is more suitable for repairing Brown class b and c defects, providing sufficient bone for implantation, while the FFF is longer and more suitable for Brown class d defect reconstruction.
旋股外侧深动脉皮瓣（DCIA）和游离腓骨瓣（FFF）是上颌骨缺损重建的主要皮瓣。本研究比较了这些皮瓣的功能结果和成功率，为中面部重建策略提供依据。
回顾性分析 2016 年 5 月至 2023 年 5 月期间在北京大学口腔医学院口腔颌面外科接受 DCIA 或 FFF 修复的上颌骨缺损患者。比较移植骨段的长度、宽度和高度、颌间距离、支撑重建率（BRR）、牙弓重建率（DAR）、成功率和种植率。
DCIA 组和 FFF 组分别有 33 例和 27 例患者。DCIA 组的成功率为 93.94%，FFF 组为 100%。DCIA 组的长度小于 FFF 组，而宽度和高度明显较大。DCIA 组 87.10%的病例为 Brown 分类 b 和 c，FFF 组 51.85%的病例为 Brown 分类 d。DCIA 组的平均 BRR 为 69.89%±16.05%，明显高于 FFF 组。DCIA 组和 FFF 组分别有 38.7%和 11.1%的患者完成了种植。
DCIA 具有更大的宽度和高度，更适合修复 Brown 分类 b 和 c 型缺损，为种植提供充足的骨量，而 FFF 更长，更适合 Brown 分类 d 型缺损的重建。
