带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网重建上颌骨缺损

目的 探讨应用带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网对上颌骨缺损行闭合式三维重建方法的可行性。方法 11例上颌骨肿瘤患者，8例行上颌骨次全切除，其余3例行上颌骨全切除，术中同期应用带蒂颊脂垫衬里和颞肌筋膜瓣联合钛网构筑上颌骨各壁，恢复上颌骨外形。结果 所有病例组织瓣全部成活，带蒂颊脂垫瓣和颞肌筋膜瓣术后4-6周上皮化，恢复鼻腔、腭部、牙槽及牙弓外形。张口度2.5-4 cm，进食时无食物从鼻腔返流，发音恢复良好，对面容外形修复效果较满意。3例上颌骨全切除的患者术后随访无复视。结论 采用带蒂颊脂垫衬里与颞肌筋膜瓣联合钛网闭合式重建上颌骨缺损的方法，可恢复患者的外形和功能，术式简单适用、风险小。

Reconstruction of Maxillary Defects Combination with Pedicled Buccal Fat Pad Graft, Temporalis Myofascial Flap and Titanium Mesh

Objective To study the feasibility of close and three- dimensional reconstruction of maxillary defects combination with pedicled buccal fat pad graft, temporalis myofascial flap and titanium mesh. Methods Among 11 patients with maxillary tumors, 9 were malignant and 2 were benign. 8 cases underwent subtotal maxillectomy and 3 cases underwent total maxillectomy. Maxillary defects were closely reconstructed combination with pedicled buccal fat pad graft (BFP), temporalis myofascial flap( TMF)and titanium mesh to restore the profile of maxilla. Results All flaps were alive with satisfactory function and aesthetic appearance. The uncovered BFP and the facial muscle sur- face of TMF epithelialized within 4- 6 weeks. Their degree of mouth opening ranged from 2.5 to 4.0 cm and without nasal foods return. All patients had a good voice quality. Conclusion Making use of BFP, TMF and titanium mesh can restore the good contour and function of maxillary. It is an effective method of reconstruction of maxillary de- fects, and is easy to manipulate. It is worthy to popularization.