颊脂垫瓣在覆盖颧骨内置牵张器中的临床应用

目的:探讨带蒂颊脂垫瓣在颧骨内置弧形牵张成骨术中,用于覆盖骨牵张器的临床应用可能性。方法:为1例行“右上颌骨全切术+左上颌骨次全切除术”的患者行颧骨内置弧形牵张成骨术,术中行带蒂颊脂垫瓣移植覆盖骨牵张器底面。术后延迟1周行骨牵引,共牵引3周,在此过程中观察颊脂垫瓣状况。结果:颧骨内置弧形骨牵张器被颊脂垫瓣及缺损区邻近剩余软组织完整覆盖,与口腔完全隔离。颊脂垫瓣术后状况良好,在牵引过程中,无破裂、感染,未见骨牵张器暴露及骨转移盘穿出。术后4周时,颊脂垫瓣表面实现上皮化,与正常黏膜难以区分。结论:带蒂颊脂垫瓣移植可以完成在颧骨内置弧形牵张成骨术中覆盖骨牵张器的任务,并具备简单、便捷、微创、效果可靠等优点,值得推广。

Application of the Pedicled Buccal Fat Pad Graft in Covering the Internal Arced Distractor During Zygoma Osteogenesis

Objective: To evaluate the feasibility and efficiency of the pedicled buccal fat pad to cover distractor in the internal arced distraction osteogenesis of zygoma.Methods: The internal arced distraction osteogenesis of zygoma was performed on a patient suffered from total(right) and subtotal(left) maxillectomy.In the operation,the pedicled buccal fat pad was used to cover the inferior surface of the distractor.One week later,the distraction osteogensis started and lasted for three weeks and the frap apperance was superused periodicaly.Results: The distractor was totally covered and separated from oral cavity by the buccal fat pad and residual soft tissue.After the surgery the graft healed well,and during the period of distraction,no infection or breakage was observed,without the distractor exposed or the bony transport disc penetrated.Four weeks after surgery,the epithelialization process completed,and the buccal fat pad graft appeared similar to the arrounding normal mucosa.Conclusion: Buccal fat pad flap can provide a simple,convenient,minimal donor morbidity and reliable solution to the distractor coverage,in the internal arced distraction osteogenesis of zygoma.