颞肌蒂下颌骨瓣修复上颌骨缺损

目的 探讨颞肌蒂下颌骨瓣修复上颌骨缺损的临床疗效.方法 2008年3月至2010年5月,应用颞肌蒂下颌骨瓣修复10例因恶性肿瘤切除造成的上颌骨缺损,其中鳞状细胞癌6例,导管癌、骨肉瘤、软骨肉瘤、恶性黑色素瘤各1例.独立修复1例,联合软组织瓣修复9例.结果10例骨瓣均成活,术后随访12 ～36个月,平均18个月,除1例软骨肉瘤患者术后复发外,其余9例面部外形和功能均恢复满意,供区未见并发症.结论 应用颞肌蒂下颌骨瓣修复上颌骨缺损具有操作简单易行、安全可靠,并发症少等优点,是修复上颌骨缺损的较理想术式.

Clinical application of mandibular osteomuscular flap pedicled with temporalis to repair maxillary bone defect

Objective To evaluate the clinical effect of mandibular osteomuscular flap pedicled with temporalis to repair maxillary defect. Methods From March 2008 to May 2010,ten cases of maxillary defects resulted from malignant tumor resection were treated with mandibular osteomuscular flap pedicled with temporalis.Ten cases of malignant tumor included six cases of Squamous cell carcinoma,one case of duct carcinoma,osteosarcoma,chondrosarcoma and malignant melanoma.One case was repaired by mandibular osteomuscular flap only,nine cases were repaired by mandibular osteomuscular flaps combined with other soft tissue flaps.Results All the 10 mandibular osteomuscular flaps survived completely with no complication. The patients were followed up for 12 to 36 months,with an average of 18 months.Satisfactory appearance and complete functional restoration were achieved except for one case of chondrosarcoma recurrence.Conclusions The mandibular osteomuscular flap pedicled with temporalis is safe and easily performed with less complication.It is an ideal method for repairing the maxillary defect.