应用钛网支架重建上颌骨肿瘤切除术后缺损畸形

目的 观察与评价采用钛网支架重建上颌骨肿瘤切除术后缺损畸形修复的效果。方法 搜集我科上颌骨肿瘤患者25例，其中良性肿瘤12例，恶性肿瘤13例；行上颌骨次全切除术15例，全上颌骨切除术10例。全部病例术中即刻行钛网修复，其中10例眶底板全切患者行上颌骨眶面及前壁结构钛网支架塑形重建，其余15例均行钛网支架上颌骨前壁缺损重建。结果 除2例失败外，23例均Ⅰ期愈合，术后2-4周复查肉芽组织覆盖口内钛网面（纤维内窥镜检查），2-3月口内创面完全愈合，10例术后3-4月行中空式膺复体修复，修复后随访，钛网支架无1例松脱及其它并发症，患者外形美观，语音和咀嚼功能恢复良好，结论 采用钛网支架重建上颌骨肿瘤术后缺损畸形能获得满意的上颌骨术后外形；术后利于观察和对复发患者进行早期处理；同期支撑眶底板缺损区，防止术后复视；联合中空式膺复体修复，可恢复患者的语音和咀嚼功能；术式简单适用，效果满意，风险小，适于基层推广。

Reconstruction of Maxillary Defects after Tumor Resection with Titanium Mesh-A Clinical Study

Objective To evaluate an ideal and practical method for maxillary defects reconstruction after tumor resection.Methods Histories of 25 cases of maxillary tumors in our department from 1998 to 2001 were reviewed.12 cases were benign and 13 cases were malignant.15cases underwent subtotal maxillectomy and reconstruction of the anterior wall of maxilla with titanium mesh alone.The other 10 cases were treated by total maxillectomy and reconstruction of the orbital floor and anterior wall of maxilla by using the same method. Results 23 cases were successfully reconstructed. 2 or 3 months follow up showed that the wounds healing and the patients' appearance were perfect. Granulation tissues were found full of the titanium mesh by NPF.10 cases were treated by prosthetic dentistry successfully without complications.Conclusion Reconstruction of maxillary defects after tumor resection with simple titanium mesh is an ideal and practical method.It has many advantages such as simple,easy to perform, easy to follow up the recurrent tumor,and both appearance and function are good.