1107例上颌骨缺损的临床分类及修复方法分析

目的：：分析上颌骨缺损的类型及修复方法,探讨二者之间的关系。方法：统计北京大学口腔医学院1985年1月至2010年12月收治的1107例上颌骨缺损病例的Brown分类及其修复方法。结果：1107例中可按Brown分类的1104例缺损中,最常见的为2a类缺损(559例,50.6%)。1107例患者中,自体组织移植修复349例,修复体修复443例,未修复107例,失访208例。应用游离皮瓣修复上颌骨缺损的比例呈增长趋势,修复体的应用呈下降趋势。上颌骨缺损重建最常用的游离皮瓣为腓骨瓣和前臂皮瓣,股前外侧皮瓣和腹直肌皮瓣较多应用于大型缺损。结论：上颌骨缺损的类型中,最多见的为Brown 2a类缺损；游离组织瓣已成为上颌骨缺损重建的最常用方法,可根据上颌骨缺损类型选择相应的游离组织瓣。

Classification and reconstruction of 1 107 cases of maxillary defects

Objective:To investigate the defect types and reconstruction methods of maxillary defects. Methods:The database of 1 107 cases with maxillary defects in Peking University School and Hospital of Stomatology from January 1985 to December 2010 was established. There construction methods were re-viewed. The defect types were classified according to Brown classification system. Results: In the 1 107 cases, 1 104 cases could be classified according to Brown classification system. The most common type was 2a with 559 cases (50. 6%). Among all the 1 107 cases, 349 cases were reconstructed with auto-transplantation, 443 cases with prosthesis, 107 cases untreated, and 208 patients lost to the follow-up. There was a significant growing trend over time for the application of free flaps and a downward trend of prosthesis. The most popular free flaps were fibular flap (88 cases) and radial forearm flap (75 cases) . Rectus abdominis flap and anterolatreal thigh flap were fit for extensive maxillary defects. Conclusion:The most common defect type is 2a. Free flap has become the dominant option for maxillary reconstruc-tion. Free flaps could be selected according to the maxillary defect types.