颧骨牵张成骨部分修复上颌骨缺损

目的：探讨应用颧骨弧形牵张成骨修复部分上颌骨缺损的临床应用可能性。方法：为1例行右上颌骨全切术,左上颌骨次全切除术患者,以自行研制的内置弧形骨牵张器行颧骨内置弧形牵张成骨术。术后延迟1w行骨牵引,共牵引3w,固定期螺旋CT观察新骨生成状况。结果：治疗内容均按计划完成。螺旋CT显示,牵引结束时,骨移动盘实现显著的改向、内旋,弧线式牵引右侧约20mm,左侧约15mm;固定期8个月时,新生骨骨质密度接近正常,与双侧正常骨质连续,弧线完整平滑,颧骨弧形牵张成骨完成,骨性支持结构于上颌骨低位建立。结论：颧骨内置弧形牵张成骨术可有效修复部分上颌骨缺损,在上颌骨低位重建骨组织支持,为进一步修复奠定良好基础,可望实现功能性重建。

Segmental reconstruction of maxillary defect by distraction osteogenesis of zygoma

Objective: To study the possibility of segmental maxillary regeneration by arced distraction osteogenesis of zygoma. Methods: The internal arced distraction osteogenesis of zygoma was performed on a patient who suffered from right total maxillectomy and left subtotal maxillectomy. In the operation,the zygoma transport disks were made and the internal arced distractors were installed. After a week of latency,the distraction started and laster for 3 weeks,osteogenesis was observed with spiral CT. Results: The patient and distractor were in good condition during the treatment. The bony transport disk was distracted around an arc about 20mm in right and 15mm in left. In the 8th month of consolidation,the new bone formed well. The density of new bone and the neighboring bone was similar to that of the normal maxilla and zygoma.The bony support was set up in low position of maxilla. Conclusion: The segmental reconstruction of maxilla could be completed by internal arced distraction osteogenesis of zygoma,bony support could be set up in low position of maxilla for further treatment.