CAJ | 학술논문

目的：探讨上颌骨及面中份缺损修复重建的方法。方法选取2004至2012年因上颌骨及面中份缺损行组织瓣重建患者22例。共使用组织瓣26块，其中游离组织瓣20块，带蒂组织瓣6块；包括前臂皮瓣14块，股前外侧肌皮瓣2块，腹直肌2块，腓骨肌皮瓣2块，颊脂体瓣2块，胸大肌皮瓣、咽上缩肌瓣、颊肌黏膜瓣及腭瓣各1块。结果26块组织瓣中1例前臂因血管栓塞失败，余组织瓣均完全成活。患者术后进食及语音功能良好。结论应用游离及局部组织瓣可较好修复上颌骨及面中份的缺损和功能。局部组织瓣仅适用中小型缺损的重建；大型上颌骨及面中份缺损宜采用游离组织瓣修复。
목적：탐토상합골급면중빈결손수복중건적방법。방법선취2004지2012년인상합골급면중빈결손행조직판중건환자22례。공사용조직판26괴，기중유리조직판20괴，대체조직판6괴；포괄전비피판14괴，고전외측기피판2괴，복직기2괴，비골기피판2괴，협지체판2괴，흉대기피판、인상축기판、협기점막판급악판각1괴。결과26괴조직판중1례전비인혈관전새실패，여조직판균완전성활。환자술후진식급어음공능량호。결론응용유리급국부조직판가교호수복상합골급면중빈적결손화공능。국부조직판부괄용중소형결손적중건；대형상합골급면중빈결손의채용유리조직판수복。
Objective To discuss the reconstruction methods for the defect in maxilla and midface. Methods From 2004 to 2012, 22 patients with maxilla and midface defect were reconstructed with vascularized free flap and pedicle flap, including 14 forearm flaps;2 anterolateral thigh flaps;2 rectus abdominis flaps;2 fibula flaps; 2 buccal fat pad falps; 1 pectoralis major flap; 1 buccinator myomucosal flap; 1 superior-constrictor myomucosal flap;1 palatal flap. Results All tissue flaps survived well except one forearm flap necrosis because of arterial thrombosis.The postoperative appearance of patient was acceptable, and the functions of swallowing and speech were normal or almost normal. Conclusions Maxilla and midface reconstruction with free tissue flap or local flap is a reliable method with good function. Local flaps can be used in small-medium defect. Free tissue flaps are more suit for large defect reconstruction.