两种血管化游离骨肌瓣移植修复下颌骨缺损临床分析

目的:评价血管化游离髂骨肌瓣和腓骨肌瓣移植修复下颌骨缺损的临床效果,比较两种修复方法的优缺点。方法:对44例血管化髂骨肌瓣和腓骨肌瓣移植修复下颌骨缺损的病例进行回顾性研究,分析两种骨肌瓣修复后对患者面部外形与口腔功能的影响,对比供受区并发症的差异。结果:20例髂骨肌瓣,24例腓骨肌瓣均成活;二者在恢复面部外形与口腔功能上无明显差异,在移植骨长度上,两者有明显不同。结论:血管化游离髂骨肌瓣与腓骨肌瓣作为下颌骨缺损修复的常用方法,可以满足不同类型下颌骨缺损修复的需要,但根据两种骨肌瓣的特点,对于缺损长度低于8 cm,可优先考虑髂骨瓣,而缺损范围大于8 cm的可选腓骨瓣。

Clinical Efficiency of Mandibular Reconstruction Using Vascularized Iliac Crest Flap and Fibular Flap.

Objective: To evaluate the clinical effect of mandibular reconstruction used vascularized iliac crest and fibular flap, and to compare their advantages and disadvantages. Methods: We conducted a retrospective analysis of 44 patients who underwent mandibular reconstruction, 20 patients with iliac crest and 24 with free fibula. The results of contour and function, complications of recipient and donor sites were analyzed according to the clinical data and follow-up. Results: All flaps survived. There was no significant difference for contour and function between the vascularized iliac crest flap and free osteofasciocutaneous fibula flap, but the length of graft bone had significant discrepancy between iliac crest and fibula. Conclusion: The two graft bones could meet the needs of the various types of mandibular defects, but it must have an option for the different site and range of mandibular defect and soft tissue defect between iliac crest flap and fibular flap. For defect whose length was less than 8cm, priority can give to iliac bone, but for defect greater than 8cm fibula flap should choose.