腓骨游离组织瓣在口腔颌面外科的应用

目的：本文结合我科应用游离腓骨瓣重建口腔下颌骨缺损的体会，论述了腓骨瓣的解剖、制作、用途及优缺点等问题。方法：腓骨瓣均以腓动、静脉为蒂，制作时采取先断腓骨，后解剖血管蒂的方法，使手术操作更容易，更安全。切取骨皮瓣时，皮岛以穿支血管为蒂，修复粘膜或皮肤缺损，或充作“监测瓣”。结果：自１９９６年１１月至１９９７年９月，我科共进行腓骨游离瓣移植术２６例，全部获得成功，９例携带皮岛者亦无１例发生坏死。结论：腓骨可提供２５ｃｍ长的皮质骨段，适于下颌骨缺损的即刻修复；还可同期或延期植入种植牙，恢复口腔的咀嚼功能，是目前修复下颌骨复合缺损的较好方法

THE USE OF FIBULA FREE FLAP IN ORAL AND MAXILLOFACIAL SURGERY

Abstract Purpose: This article discusses the anatomy, surgical technique, application, advantage and disadvantage of the fibula free flap in oral and maxillofacial reconstruction, based on our clinical experience.Methods: The fibula free flap was based on the peroneal vessel. In harvesting the flap, the fibula was osteotomized proximally and distally first, then the vascular pedicle was dissected, which made the procedure easier and safer. The skin paddle of the osteocutanous flap was based on the perforators and used to repair mucosal or skin defect, or as an external “monitor”.Results: Between Nov. of 1996 and Sept. of 1997, 26 fibula free flaps were performed (including 9 osteocutaneous flaps) in our department. All flaps survived well without failure.Conclusions: The fibula free flap can provide a bicortical segement as long as 25cm, which is suited to repair the mandibular defect immediately. The flap can allow x immediate or secondary inset of osseointegrated implants to rehabilitate mastication. It is believed to be the more ideal method for reconstruction of composite mandibular defects currently.