摘要
目的:观察和评价应用CAD/CAM的中空充填式赝复体(简称CAD/CAM赝复体)同期修复上颌窦癌上颌骨全切除缺损后患者的面容及功能恢复情况。方法:18例T3-4a N0M0上颌窦癌行上颌骨全切除患者,应用CAD/CAM赝复体同期修复缺损。术后1、3、6个月定期复查,比较患者戴与不戴CAD/CAM赝复体时以及13例更换永久性赝复体的患者术后12个月戴与不戴赝复体时,面容、语音清晰度、咀嚼、吞咽情况。采用SPSS 13.0软件包对数据进行统计学处理。结果:18例患者术后1、3、6个月戴与不戴CAD/CAM赝复体比较,语音清晰度(t值分别为29.38、136.24),面部凹陷度(t值分别为2.73、4.74和5.92),眼球下坠(t值分别为8.20、15.17和14.74)均有显著差异(P<0.05)。吞咽功能由Ⅳ级到Ⅱ级,提高结果为显效。咀嚼问卷平均23分,能咀嚼硬性和一般食物。13例术后6个月更换永久性赝复体的患者,语音更清晰(t值为102.34,P<0.05)。结论:上颌窦癌上颌骨全切除术后,应用CAD/CAM赝复体修复缺损,面容及功能恢复良好,患者生活质量明显提高;可直接观察上颌骨区域的术腔变化,便于肿瘤复发的及时发现和处理,是上颌窦癌患者上颌骨全切除后同期修复缺损及重建功能的首选方案之一。
PURPOSE：To observe and investigate the facial profiles and functional recovery in patients with CAD/CAM obturator prosthesis after total maxillectomy for malignant tumor. METHODS：Eighteen patients with T3-4a N0M0 maxillary malignant neoplasm were treated by total maxillectomy and immediate CAD/CAM obturator prostheses repair. The patients were followed up and underwent examinations at 1-,3- and 6-month after surgery. The facial features, pronunciation clarity, deglutition and mastication were evaluated in the patients with and without CAD/CAM prosthesis simultaneously or permanently. SPSS13.0 software package was used for statistical analysis. RESULTS：Postoperative follow-up showed that there were significant differences in pronunciation clarity （t=29.38, 136.24, respectively, P＆lt;0.05）, mid -facial region collapse （t =2.73, 4.74, 5.92, respectively, P ＆lt;0.05）, and eyeball sagging （t =8.20, 15.17, 14.74, respectively, P ＆lt;0.05） between patients with and without CAD/CAM prosthesis. Swallowing ability was significantly improved from Class IV to Class II. The average score was 23 in the questionnaires regarding to chewing ability, indicating patients could chew hard and ordinary food. Thirteen patients wore the permanent prothesis at 6-month after surgery with clearer pronunciation （t =102.34, P ＆lt;0.05）. CONCLUSION：Repair of maxillofacial defect with immediate CAD/CAM prosthesis after maxillectomy can preserve the facial features and improve the quality of life. The postoperative maxillary space can be directly observed during follow-up. This treatment modality is one of the preferred options in patients with maxillary malignant tumor after total maxillectomy.
出处
《中国口腔颌面外科杂志》
CAS
2013年第4期319-324,共6页
China Journal of Oral and Maxillofacial Surgery
关键词
上颌窦癌
赝复体
CAD
CAM
效果评价
Maxillary sinus carcinoma
Denture prosthesis
CAD/CAM
Quality of life
