Haughey B H, Fredrickson J M, Lerrick A J, Sclaroff A, Gay W D
Department of Otolaryngology, Wasington University School of Medicine, St Louis, Mo 63110.
Laryngoscope. 1994 Nov;104(11 Pt 1):1305-13. doi: 10.1288/00005537-199411000-00001.
A method for reconstruction of oral cavity soft tissues using segmentally or axially supplied free muscle flaps harvested as a unit with their bone components is presented. Both fibular/soleus and iliac crest/internal oblique free flaps are documented, and the pros and cons of each donor site are presented. Twenty-one patients, 17 with cancer or osteoradionecrosis and 4 with benign or congenital conditions of the mandible, have undergone this operation. Ten bone grafts were simultaneously embedded with osseointegrated implants. All free flaps except one survived and resulted in a smoothly mucosalized oral lining. Six patients have had their implants successfully uncovered, all of whom are wearing prostheses. Four other patients are using tissue-borne prostheses. Transfer of free, nonbulky muscle flaps for mucosalized oral soft-tissue reconstruction is feasible in selected patients using first the fibular and, second, the iliac donor site; this soft-tissue technique also contributes to prosthetic dental rehabilitation.
本文介绍了一种使用与骨成分作为一个整体获取的节段性或轴向供血的游离肌皮瓣重建口腔软组织的方法。记录了腓骨/比目鱼肌和髂嵴/腹内斜肌游离皮瓣，并阐述了每个供区的优缺点。21例患者接受了该手术，其中17例患有癌症或放射性骨坏死，4例患有下颌骨良性或先天性疾病。同时植入了10块骨移植体及骨整合种植体。除1例游离皮瓣外，其余均存活，口腔黏膜化良好。6例患者的种植体成功暴露，均已佩戴假牙。另外4例患者使用组织支撑式假牙。对于部分患者，首先使用腓骨供区，其次使用髂骨供区，转移游离、不臃肿的肌皮瓣进行黏膜化口腔软组织重建是可行的；这种软组织技术也有助于义齿修复。
