钛网填以松质骨修复上颌骨的临床探讨

目的 体验和探讨在预制钛网支架内填塞自体髂骨松质骨,并以颞肌瓣进行覆盖,修复上颌骨缺损的治疗方法、效果以及其临床意义。方法 6例上颌骨缺损患者,术前预制钛网支架。术中采用钛钉固定在缺损处,网架内填塞自体髂骨松质骨,颞肌瓣包绕钛网支架修复上颌骨缺损。结果 6例患者植入的松质骨及覆盖的颞肌瓣全部存活。术后6个月X片显示:松质骨生长良好。结论 上颌骨不同类型的缺损均可应用此方法进行功能性修复,此方法与其它游离骨复合瓣比较而言,安全系数高,对患者的创伤小,充分体现个性化特点。

RECONSTRUCTION OF THE MAXILLARY DEFECTS WITH TITANIUM MESH FILLED WITH CANCELLOUS BONE

Objective To study and experience a method for functional reconstruction of the maxilla:a titanium mesh packed with autogenous cancellous bone and covered by temporalis myofascial flap. Methods Among this group, 5 patients had maxillary tumor, 1 patient suffered injury. The titanium mesh is designed preoperatively based on the model of the patients maxilla. The titanium mesh is packed with autogenous cancellous bone and is fixed to the region of the maxillary defect. The custom-made titanium mesh is covered by two layers of a pedicled temporalis muscle flap. Results The result showed that the uncovered temporalis muscle flap in the mouth underwent a consistent healing commencing with an acute inflammatory phase to eventual epithelialization by oral mucosa. 6 months after the operation, the X-rays showed that cancellous bone developed finely. Conclusion This method can be used to restore the varied types of the the maxillary defects.