应用钛网支架及前臂游离皮瓣修复上颌部肿瘤切除后洞穿缺损

目的 探讨应用钛网支架与前臂游离皮瓣即刻修复上颌骨部分洞穿缺损的手术方法.方法 对2004年至2008年收治的19例上颌部肿瘤患者,于切除肿瘤后即刻应用钛网支架修复骨质缺损,并以前臂游离皮瓣覆盖于钛网支架表面修复口腔黏膜缺损.结果 19例中16例患者术后功能与外形均获得较为满意的效果,患者发音清晰,进食时无口鼻腔返流现象;有3例术后钛网支架部分外露、感染,遂去除钛网支架,将挛缩的前臂游离皮瓣重新展开,并缝合于缺损部位,口鼻腔瘘得到关闭,患者的发音、进食功能无明显影响,仅面中部有轻度塌陷.结论 应用钛网支架与前臂游离皮瓣修复上颌部缺损是一种简单、可行的方法,吞咽与语言功能得到较好的维护,同时也获得了较为满意的面部外形.

Application of titanium mesh and free forearm flap for reconstruction of maxillary defect resulted from tumor resection

Objective To investigate the application of titanium mesh and free forearm flap for reconstructiou of maxillary defect resulted from tumor resection. Methods From 2004 to 2008, 19 cases with maxillary tumor underwent tumor resection. The defects were reconstructed immediately with titanium mesh for bony defects and fiee forearm flap for oral mucosa defects. Results 16 cases achieved satisfactory functional and cosmetic results. The speech assessment was good without orounsal reflux. The titanium mesh was exposed and infected in 3 cases. Then the meshes were taken out and the defects were covered with the forearm flap to close the oronasal fistule. The midface was slightly depressed with no functional morbidity. Conclusions It is simple and practical to reconstruct maxillary defect with titanium mesh and free forearm flap. Both the functional and cosmetic results are satisfactory.