游离前臂皮瓣颊脂垫修复上颌骨缺损的临床评价

目的评价游离游离前臂皮瓣、颊脂垫修复上颌骨缺损的临床效果。方法根据上颌骨切除后的修复方式分为两组:手术组10例,即上颌骨切除后立即行游离游离前臂皮瓣、颊脂垫修复的患者;赝复体组10例,即上颌骨切除后未行修复,术后佩戴赝修复体的患者。通过鼻咽纤维镜检查、语音清晰度测试、咀嚼效率测量,对两组患者在语言、咀嚼、腭咽闭合方面行功能性评价。结果手术重建组咀嚼效率75%～95%,平均82.5%,赝复体组咀嚼效率为50%～82%,平均64.5%,两组差异有统计学意义(P<0.05);手术组语音清晰度94%～96%,平均95.2%,赝复体组语音清晰度70%～86%,平均79.5%,两组差异有统计学意义(P<0.05);手术组完全性腭咽闭合率是90%,赝复体组为零,两组差异有统计学意义(P<0.05)。结论用游离前臂皮瓣、颊脂垫修复上颌骨缺损较传统修复方法更有效地恢复上颌骨功能和结构,是上颌骨缺损修复的良好选择。

Clinical Evaluation of Maxillary Reconstruction with Radial Forearm Flap and Buccal Fat Pad

Objective To evaluate the clinical effectiveness of maxillary reconstruction with radial forearm flap and buccal fat pad.Methods According to the rehabilitative methods of maxillary defeats,patients were divided into two groups,One was the surgical rehabilitation group(10 cases) in which the maxillary defects were reconstructed with radial forearm flap and buccal fat pad.The other was prosthodontic rehabilitation group(10 cases) in which the maxillary defects were covered with the traditional prothesis.The clinical effectiveness of two groups was evaluated in masticatory efficiency,speech intelligibility and palatopharyngeal valve.Results The masticatory efficiency in surgical rehabilitation groups was 75%-95%(mean 82.5%),the masticatory efficiency in prosthodontic rehabilitation groups was 50%-82%(mean 64.5%),there was significant difference between groups by using student test(P<0.05);The speech intelligibility in surgical rehabilitation group was 94%-96%(mean 95.2%),in prosthodontic rehabilitation groups was 70%-86%(mean 79.5%),there was significant difference between groups by using student test(P<0.05);Palatopharyngeal valve sufficiency rate in surgical rehabilitation group was 90%,in prosthodontic rehabilitation groups was zero,there was significant difference between groups by using student test(P<0.05).Conclusion Maxillary reconstruction with radial forearm flap and buccal fat pad can better restore the function and structure of maxilla than that with traditional prothesis.It is a good choice for maxillary reconstruction.