外科模板在游离腓骨瓣修复上颌骨缺损术中的应用

目的 探讨外科模板在上颌骨切除同期自体腓骨瓣移植修复术中的作用。方法 7例因上颌骨肿瘤需行上颌骨切除术并同期自体腓骨瓣修复的患者，术前取研究模型，根据拟行的手术范围进行模型外科设计，确定牙槽突缺损范围，并将模型修整成需要重建的理想解剖形态，制作模板。外科医生在术中根据模板对腓骨瓣塑形，并确定腓骨瓣固定的位置。术后取研究模型观测腓骨瓣的就位情况，三维CT评价腓骨与下颌骨的相对位置关系。结果 经过外科模板的术中定位，腓骨瓣与下颌骨达到正常相对位置关系，垂直向间隙适合常规叉齿或种植义齿修复。患者戴用义齿后的咀嚼效率明显提高。结论 外科模板是修复医生和外科医生之间有效的交流载体，为患者术后功能和外形的恢复创造了有利条件。

The effect of surgical template for maxillary reconstruction with free fibula flap

Objective To determine the effect of surgical template for maxillary reconstruction with free fibula flap.Methods Diagnostic models of 7 patients with maxillary reconstruction by free fibula flap were taken before surgery.Model surgeries were performed according to the design of maxillectomy and the models were modified to ideal appearance and location,then surgical templates were made based on the results of model surgery.During the surgery,the surgical template is helpful for the surgeons to determine the position of fibula bone.Study models and 3D-CT were taken to estimate the contourand relative position of the fibula bone to mandible after surgery.Results The correct relative position and vertical space of fibula bone to the mandible could be achieved under the guide of surgical template.The masticatory efficiency of the patients with conventional prosthesis increased significantly.Conclusion Surgical template could give effective communication between prosthetists and surgeons,and could facilitate the restoration of maxillary function and contour.