下颌骨缺损修复方法的研究

目的：选择理想的下颌骨缺损修复方法和时机,重建下颌骨患病前的外形,恢复患病前的咬合关系,纠正颌面畸形,提高患者的生存质量恢复正常吞咽功能和咀嚼功能。分析下颌骨缺损修复重建中不同办法的临床效果。方法：收集1999年7月至2009年1月在我院颌面外科因各类肿瘤切除手术后实施下颌骨缺损修复重建的患者76例,比较76例下颌骨缺损患者修复方法的优缺点,分析与下颌骨修复方法选择相关的各种因素。结果：自体游离骨移植同期修复下颌骨缺损者63例,占82.8%,其中4例因术后感染失败。5例吻合血管的自体骨移植全部存活,修复效果理想。结论：自体游离骨移植是目前最常用的修复办法,但是适用范围局限。血管化骨移植是目前最理想的修复方法,但不是所有患者都适合。各类下颌骨缺损应考虑同期修复,应结合患者自身多种因素综合考虑修复重建的办法。

RESEARCH ON REPAIR METHOD OF MANDIBULAR DEFECT

Objective：To study the repair methocl of mandibular.Methods： 76 cases of mandibular recon-struction following tumour dissection in hospital from July 1999 to Jan.2009 were collected.The merits and de-merits of reconstruction of the mandibular defects of 76 cases were analyzed.Factors related to the selection of mandibular reconstruction methods were analyzed.Results： Reconstruction of the mandibular defects of autoge-nous bone took up 82.8%（63/76）.The success rate of this approach in 63 cases was93.6%（59/63）,while failed rate was 6.3%（4/63）.Vascularized and iliac transplants for mandibular reconstruction were totally successful.Conclusions： Free autogenous bone graft is usually applied in the construction of mandibular defects based on careful patients selection.Vascularized bone transplantation for mandibular reconstruction is an ideal method,but not necessary in all patients.