Zou Jiaojiao, Hou Xiaoru, Wang Lin, Li Lifeng, Li Yanqiu, Hu Xiaoyi, Xing Xiaotao
Key laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University. Xi'an 710000, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2025 Apr;34(2):218-224.
To summarize and evaluate the clinical effectiveness of the pedicled buccal fat pad combined with a mucoperiosteal composite flap in preventing and closing oroantral fistula.
This study included a total of 12 patients who underwent closure of surgical incisions following treatment of posterior maxillary lesions using a pedicled buccal fat pad combined with a mucoperiosteal composite flap. In all cases, the pedicled buccal fat pad was placed beneath the local mucoperiosteum to form a composite flap for incision closure. The retrospective analysis encompassed patients' baseline data, including age, gender, diagnosis, clinical symptoms, imaging characteristics, surgical procedures, and treatment outcomes. Additionally, the analysis included an evaluation of the local functional outcomes in the operative area.
Among the 12 patients, there was an equal distribution of males and females (1∶1 ratio), with an average age of (35.83±20.17) years. Among them, 8 cases had cystic lesions in the maxillary posterior region, 3 cases had oroantral fistula, and 1 case had maxillary comminuted fracture. All patients (100%) underwent surgery involving the maxillary posterior dental region adjacent to the maxillary sinus. Preoperative symptoms included swelling, pain, halitosis, and occlusal disorder. CT imaging revealed that bone destruction in the posterior maxilla frequently affected multiple teeth, often with impacted teeth, and showed a close association with the maxillary sinus. Buccal bone resorption or destruction was the predominant feature in the operative area, and after removal of the diseased teeth, limited buccal bone remained. Wound closure was achieved using a buccal fat pad/mucoperiosteal composite flap technique. During the follow-up period, all 12 patients healed successfully, with no occurrences of oral-nasal fistula. Additionally, no significant changes in buccal morphology or vestibular groove were observed.
The use of a pedicled buccal fat pad combined with a mucoperiosteal composite flap is effective in sealing and preventing oroantral fistula, improving clinical symptoms in cases involving oroantral fistula and maxillary posterior bone resorption during surgery.
总结并评估带蒂颊脂垫联合黏骨膜复合瓣在预防和封闭口腔上颌窦瘘方面的临床疗效。
本研究共纳入12例患者，这些患者在接受上颌后牙区病变治疗后，采用带蒂颊脂垫联合黏骨膜复合瓣进行手术切口关闭。所有病例中，将带蒂颊脂垫置于局部黏骨膜下方，形成复合瓣用于切口关闭。回顾性分析涵盖患者的基线数据，包括年龄、性别、诊断、临床症状、影像学特征、手术过程及治疗结果。此外，分析还包括对手术区域局部功能结果的评估。
12例患者中，男女比例为1∶1，平均年龄为（35.83±20.17）岁。其中，8例上颌后牙区有囊性病变，3例有口腔上颌窦瘘，1例有上颌骨粉碎性骨折。所有患者（100%）均接受了上颌后牙区紧邻上颌窦的手术。术前症状包括肿胀、疼痛、口臭和咬合紊乱。CT影像学显示，上颌后牙区骨质破坏常累及多颗牙齿，常伴有阻生牙，且与上颌窦关系密切。颊侧骨吸收或破坏是手术区域的主要特征，拔除患牙后，颊侧剩余骨量有限。采用颊脂垫/黏骨膜复合瓣技术实现了伤口关闭。随访期间，12例患者均顺利愈合，未发生口鼻瘘。此外，未观察到颊部形态或前庭沟有明显变化。
带蒂颊脂垫联合黏骨膜复合瓣用于封闭和预防口腔上颌窦瘘有效，可改善涉及口腔上颌窦瘘及手术中上颌后牙区骨质吸收病例的临床症状。
