摘要
目的:探讨利用血管化游离腓骨瓣(free fibular flap, FFF)重建面下1/3软硬组织缺损的方法,评价利用腓骨瓣修复下颌骨缺损的多样性及灵活性。方法:收集因良、恶性肿瘤行下颌骨节段性切除同期行腓骨瓣修复的患者35例,统计患者下颌骨缺损类型、术前设计、腓骨瓣修复方法及携带皮岛的情况。结果:根据COM分类法进行分类,Ⅰ类6例、Ⅱ类26例、Ⅲ类3例,缺损长度为4.85~17.00 cm,平均(8.29±2.69)cm。单层腓骨瓣修复28例,其中1例单层腓骨宽达2.16 cm;折叠腓骨瓣修复6例;单层腓骨瓣+游离植骨1例,共8例患者下颌骨高度得到完美恢复。皮岛方面,因穿支缺如无皮岛者1例,30例携带1个皮岛,4例携带双皮岛,软组织缺损修复效果良好。结论:血管化FFF应用灵活,除能恢复下颌骨连续性外,还可以通过多种手段恢复下颌骨高度,并携带双皮岛修复复杂的软组织缺损。
Objective:To evaluate the diversity and flexibility of vascularized free fibular flap(FFF)for soft and hard tissue defects of the lower third of face and oromandibular reconstruction.Methods:We collected 35 patients who underwent segmental resection of the mandible due to benign or malignant tumors and reconstructed with vascularized FFF.The types of mandibular defects,preoperative design,methods of FFF reconstruction and categories of skin islands were analyzed.Results:According to the COM classification,there were 6 cases of typeⅠ,26 cases of typeⅡand 3 cases of typeⅢ.The length of the mandibular defects ranged from 4.85 cm to 17.00 cm,with an average of(8.29±2.69)cm.Among them,28 cases were reconstructed with vascularized FFF,in which the width of the monolayer fibula was 2.16 cm in one case;6 cases were rebuilt with folded vascularized FFF;1 case was restored with monolayer vascularized FFF plus non‐vascularized free fibula.Therefore,totally 8 cases perfectly restored the height of the mandible.In terms of skin islands,1 case had no skin island due to the absence of peroneal perforator,30 cases carried 1 skin island,4 cases carried double skin islands,the soft tissue defects were well restored.Conclusion:The vascularized FFF has the advantage of flexibility.In addition to restoring the continuity of the mandible,it can rebuild the height of the mandible through a variety of ways.Besides,it can also carry double skin islands to repair complex soft tissue defects.
作者
宋丽娜
吴春月
秦清岩
楚天舒
刘麒麟
SONG Lina;WU Chunyue;QIN Qingyan;CHU Tianshu;LIU Qilin(The 3rd Department of Oral and Maxillofacial Surgery,Hospital of Stomatology,Jilin University,Changchun 130021,Jilin Province,China)
出处
《口腔颌面外科杂志》
CAS
2023年第2期104-110,共7页
Journal of Oral and Maxillofacial Surgery
基金
国家自然科学基金(81600890)。
关键词
血管化腓骨瓣
下颌骨缺损
修复重建
皮岛
vascularized free fibula flap
mandibular defect
reconstruction
skin island
