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颊脂肪垫瓣在修复口腔颌面部缺损中的应用 总被引:2,自引:0,他引:2
目的探讨颊脂肪垫瓣在修复口腔颌面部缺损的应用和效果.方法将颊脂肪垫形成一蒂在后方的颊脂肪垫组织瓣转移至缺损区,在无张力下与创缘缝合,表面轻轻用碘仿纱布缝线包压法固定.用以修复口腔颌面部的良恶性肿瘤手术或损伤留下的缺损以及口腔上颌窦瘘共18例.其中修复腭部缺损2例,上颌骨切除后缺损7例,颊黏膜癌切除后缺损3例,颊部良性肿瘤切除后缺损4例,磨牙后区黏表癌切除后缺损1例,封闭拔牙后口腔上颌窦瘘1例.结果术后10 d去除碘仿纱布,见颊脂肪垫轻度水肿,2~4周后水肿明显消退,颊脂肪垫表面逐渐上皮化,6~8周内表面完全上皮化,3个月后再生黏膜与正常口腔黏膜相似.全部病例效果满意,无感染、坏死等并发症发生.结论带蒂颊脂肪垫瓣修复口腔颌面部缺损,方法简单、易行,效果满意,值得推广. 相似文献
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目的评价腭部黏膜下组织瓣在口腔上颌窦瘘修复中的效果。方法对12例口腔上颌窦瘘患者,采用腭部黏膜下组织瓣修复缺损。结果术后创口均愈合良好,黏膜下结缔组织瓣修复区及腭部供区黏膜颜色、光滑度及质地均恢复良好。结论腭部黏膜下组织瓣能有效地修复口腔上颌窦瘘,术后无明显供区并发症发生。 相似文献
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预成钛网结合颊脂垫瓣和自体植骨修复上颌骨缺损 总被引:2,自引:0,他引:2
目的介绍一种以钛网支架结合带蒂颊脂垫瓣和自体植骨移植,行上颌骨缺损个体化三维重建的手术方法。方法自2001年5月迄今,对16例上颌骨因肿瘤及外伤后缺损者,分别以三维CT及快速原型技术预成实体模型,通过CAD/CAM将健侧上颌骨复制到患侧缺损部位,在模型上塑形精确钛网,结合带蒂颊脂垫瓣内衬钛网内侧,行自体植骨以重建上颌骨形态和功能。结果16例上颌骨缺损于修复术后6-36个月随访观察,创口均一期愈合,面部轮廓对称,进食时无食物从鼻腔返流。16例中8例钛网支架结合带蒂颊脂垫瓣移植并行自体植骨上颌骨缺损重建者,已行可摘局部义齿修复,能进普食,语言清晰,活动义齿修复功能良好。3例上颌骨功能性重建术后5-12个月经鼻咽内窥镜检查,发现钛网内衬有正常软组织覆盖。结论本手术方法使术后患者上颌骨外形和口腔功能得到改善,且将带蒂颊脂垫植入上颌窦黏膜与钛网之间,避免了移植物的暴露,血管化的颊脂垫不仅有助于自体骨与钛网支架较好的结合,同时能恢复部分上颌窦的正常生理功能。 相似文献
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目的介绍颊脂垫瓣移转的应用原理及用以腭裂修复的实践。方法将颊脂垫瓣移植于硬腭裂隙的口腔侧创面,或充填于腭部的口腔与鼻腔侧组织瓣之间,尤其是硬软腭交界处。颊脂垫不需用皮片覆盖,可以自行上皮化。结果共治疗腭裂6例,术后颊脂垫完全成活,无腭瘘形成,无颊间隙感染发生。2周后,颊脂垫自行上皮化。结论颊脂垫血供丰富,易于成活,可为Ⅱ期愈合的创面提供肉芽组织再生床,改善软硬组织血供,以促进伤口的愈合。使通过常规的手术方法不能或难以修复的大的裂隙或缺损得以修复 相似文献
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颊脂垫瓣移转在腭裂修复中的应用 总被引:4,自引:0,他引:4
介绍颊脂垫瓣移转的应用原理及用以腭裂修复的实践。方法 将颊脂垫瓣移植于硬腭裂隙的口腔侧创面,或充填于腭部的口腔与鼻腔侧组织瓣之间,尤其是硬软腭交界处。颊脂垫不需用皮片覆盖,可以自行上皮化。结果 共治疗腭裂6例,术后颊脂垫完全成活,无腭瘘形成,无颊间隙感染发生。 相似文献
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应用单侧岛状颊肌黏膜瓣和双反向双Z成形术修复宽大腭裂 总被引:1,自引:0,他引:1
目的应用单侧岛状颊肌黏膜瓣加双反向双Z成形术修复较宽大的腭裂,延长软腭,不做牙槽弓内侧松弛切口,腭部无骨性创面裸露和瘢痕形成,以减少或避免对上颌骨和牙槽弓生长发育的影响。方法应用改良的双反向双Z成形术延长软腭,裂缘蒂的口腔侧黏骨膜瓣翻转关闭鼻腔侧的裂隙,一侧岛状颊肌黏膜瓣修复腭部口腔侧创面,牙槽弓内侧不做松弛切口。结果应用该法共治疗36例,2例出现了腭瘘,其余伤口愈合良好,软腭延长显著,无组织瓣坏死、伤口感染、张口困难、面神经损伤等并发症发生。随访8例患者,均获得完善的腭咽闭合功能。结论一侧岛状颊肌黏膜瓣与双反向双Z成形术联合应用修复较宽大的腭裂,既延长了软腭,又避免了腭部骨性创面裸露、瘢痕形成而影响上颌骨和牙槽弓生长发育,是一项安全可靠的手术。 相似文献
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目的探讨颈阔肌肌皮瓣修复口腔癌术后组织缺损的方法及可行性。方法2003年3月~2004年6月,应用颈阔肌肌皮瓣修复舌、口底、颊、咽侧壁及软腭缺损15例。其中男12例,女3例,年龄41~77岁。颊癌11例,舌癌1例,口底癌2例,咽侧壁及软腭癌1例。均行病变及颈淋巴根治性切除,缺损范围3.0 cm×3.5 cm~7.0 cm×4.0 cm,应用颈阔肌皮瓣修复软组织缺损,皮瓣范围7.0 cm×3.5 cm~12.0 cm×4.0 cm。结果术后15例皮瓣均成活,肌皮瓣色泽与皮肤相似,外形无异常,张口不受限。术后10~15 d出现颊部皮瘘8例,术后4周二期断蒂修补后完全愈合。随访6~12个月,无舌运动受限等并发症,肿瘤无复发,患者对术后形态及功能均较满意。结论颈阔肌肌皮瓣血运丰富,抗感染力较强,成活率高,是修复口腔组织缺损行之有效的方法,手术方法简便,值得推广。 相似文献
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Simultaneous vascularized bony reconstruction of the maxilla and mandible using a single fibula: A case report
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Alexander F. Mericli M.D. Jonathan S. Friedstat M.D. Edward I. Chang M.D. Matthew M. Hanasono M.D. 《Microsurgery》2017,37(3):243-247
Simultaneous maxillary and mandibular reconstruction is exceedingly rare. These are complicated cases, requiring consideration of multiple variables: defect components, donor site morbidity, recipient vessels, and so forth. We describe a unique case of secondary maxillary/mandibular reconstruction in a 59‐year‐old male. The original defect was created after removal of a buccal squamous cell carcinoma, involving the external cheek skin, buccal mucosa, right mandibular body, and right inferior maxilla; a free vertical rectus abdominis musculocutaneous flap was used for the initial reconstruction. At the time of presentation to our clinic, the patient was tube‐feed‐dependent, unable to speak, and distressed regarding his appearance. We revised his reconstruction, rebuilding his maxilla and hemimandible using two free fibula flaps from a single fibula. The fibulae were vascularized via vein grafts and an ALT flap was used for external cheek resurfacing. All flaps survived and there were no complications at seven months since his surgery (when this report was written). The patient had intelligible speech and maintained adequate nutrition with a soft diet. Simultaneous vascularized bony reconstruction of the maxilla and mandible using a single fibula flap may be performed safely and with good outcomes. 相似文献
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目的探讨颏下动脉岛状瓣在修复颜面部软组织缺损中的应用。方法2007年7月至2014年3月,收治颜面部软组织缺损患者10例,其中外伤2例,面部鳞癌4例,面部基底细胞癌1例,烫伤或烧伤后瘢痕增生3例。根据缺损位置及大小设计颏下动脉岛状瓣进行修复,最小为3cm×6cm,最大为4cm×10cm。结果术后皮瓣存在不同程度的肿胀苍白及淤血,5d后逐渐改善。1例皮瓣远端出现坏死,经换药处理愈合。术后随访3~12个月,3例供皮区采用全厚皮覆盖创面,随访期间发现皮片不同程度收缩。其余受区外观及功能均较满意,供区瘢痕隐蔽。结论颏下动脉岛状瓣与面部软组织在质地、颜色上非常相似,皮瓣血供可靠,成活率高,是修复颜面部软组织缺损的较好选择。 相似文献
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Background: Reconstruction following excision of intraoral tumours presents a challenge to the head and neck surgeon. The purpose of the present study was to review the authors' initial experience with the temporalis muscle flap. Methods : A retrospective review of the use of 21 temporalis muscle flaps in intraoral reconstruction at Christchurch Hospital was performed. The muscle was used to reconstruct defects of the oral tongue, tongue base, buccal mucosa, maxilla, soft palate, retromolar trigone and tonsillar region. Epithelial cover was provided by either split-skin grafting or ingrowth from adjacent mucosa. Results: One flap necrosed and one patient developed a wound haematoma requiring drainage. One patient developed a transient frontal weakness. The long-term functional results were excellent, except for one patient with slight tongue tethering. In one patient bilateral flaps were used to reconstruct a bilateral maxillectomy defect. Conclusion : The temporalis muscle flap is a useful option for reconstruction of moderate defects in the posterior oral cavity and oropharynx. 相似文献