中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2015年
2期
85-88
,共4页
夏德林%付光新%马征%吴双江%张磊%贾娟
夏德林%付光新%馬徵%吳雙江%張磊%賈娟
하덕림%부광신%마정%오쌍강%장뢰%가연
髂骨%腹内斜肌%缺损%下颌骨
髂骨%腹內斜肌%缺損%下頜骨
가골%복내사기%결손%하합골
Iliac crest%Internal oblique muscle of abdomen%Defect%Mandible
目的 探讨腹内斜肌-髂骨复合组织瓣在半侧下颌骨缺损修复中的效果.方法 2009年7月至2013年9月,应用以旋髂深动、静脉为蒂的腹内斜肌-髂骨复合组织瓣,对14例因肿瘤切除所致的半侧下颌骨缺损进行修复.手术分2组同时进行,一组切除肿瘤并准备受区血管,一组切取腹内斜肌-髂骨复合组织瓣.将制备好的组织瓣修整塑形固定后吻合血管.结果 14例腹内斜肌-髂骨复合组织瓣均存活,1例受区伤口局部感染,经换药后痊愈.切取髂骨最小6 cm×3 cm,最大9 cm×3 cm,腹内斜肌瓣最小5 cm×4 cm,最大7 cm×5 cm.术后随访6~ 26个月,平均13个月,颌面部外形满意、双侧对称,供区未见并发症.下颌曲面断层片显示移植髂骨断端新骨形成良好、下颌骨连续,骨纹理清晰.结论 腹内斜肌-髂骨复合组织瓣具有骨量充足、重建下颌骨高度足够、外形功能恢复好、软硬组织同期重建等优点,是修复半侧下颌骨复合组织缺损的较好方法.
目的 探討腹內斜肌-髂骨複閤組織瓣在半側下頜骨缺損脩複中的效果.方法 2009年7月至2013年9月,應用以鏇髂深動、靜脈為蒂的腹內斜肌-髂骨複閤組織瓣,對14例因腫瘤切除所緻的半側下頜骨缺損進行脩複.手術分2組同時進行,一組切除腫瘤併準備受區血管,一組切取腹內斜肌-髂骨複閤組織瓣.將製備好的組織瓣脩整塑形固定後吻閤血管.結果 14例腹內斜肌-髂骨複閤組織瓣均存活,1例受區傷口跼部感染,經換藥後痊愈.切取髂骨最小6 cm×3 cm,最大9 cm×3 cm,腹內斜肌瓣最小5 cm×4 cm,最大7 cm×5 cm.術後隨訪6~ 26箇月,平均13箇月,頜麵部外形滿意、雙側對稱,供區未見併髮癥.下頜麯麵斷層片顯示移植髂骨斷耑新骨形成良好、下頜骨連續,骨紋理清晰.結論 腹內斜肌-髂骨複閤組織瓣具有骨量充足、重建下頜骨高度足夠、外形功能恢複好、軟硬組織同期重建等優點,是脩複半側下頜骨複閤組織缺損的較好方法.
목적 탐토복내사기-가골복합조직판재반측하합골결손수복중적효과.방법 2009년7월지2013년9월,응용이선가심동、정맥위체적복내사기-가골복합조직판,대14례인종류절제소치적반측하합골결손진행수복.수술분2조동시진행,일조절제종류병준비수구혈관,일조절취복내사기-가골복합조직판.장제비호적조직판수정소형고정후문합혈관.결과 14례복내사기-가골복합조직판균존활,1례수구상구국부감염,경환약후전유.절취가골최소6 cm×3 cm,최대9 cm×3 cm,복내사기판최소5 cm×4 cm,최대7 cm×5 cm.술후수방6~ 26개월,평균13개월,합면부외형만의、쌍측대칭,공구미견병발증.하합곡면단층편현시이식가골단단신골형성량호、하합골련속,골문리청석.결론 복내사기-가골복합조직판구유골량충족、중건하합골고도족구、외형공능회복호、연경조직동기중건등우점,시수복반측하합골복합조직결손적교호방법.
Objective To investigate the effect of vascularized composite flap with iliac crest and internal oblique muscle of abdomen for half mandibular reconstruction.Methods From July 2009 to Sept.2013,14 cases with half mandibular defect after tumor resection were treated with composite flap of iliac crest and internal oblique muscle of abdomen pedicled by deep circumflex iliac vessels.During operation,one group performed tumor resection and got the recipient area vessels ready for anastomosis.The other group performed harvesting of composite flap.Then the flap was trimmed and fixed to construct the defect with vessel anastomosis.Results All the 14 composite flaps survived with local infection only in 1 case.The size of harvested iliac crest ranged from 6 cm × 3 cm to 9 cm× 3 cm.The size of harvested internal oblique muscle of abdomen ranged from 5 cm× 4 cm to 7 cm× 5 cm.The patients were followed up for 6 months to 26 months (mean,13 months) with satisfactory results and no complication.Mandibular panoramic radiographs showed new bone formation and good union.Conclusions Vascularized composite flap with iliac crest and internal oblique muscle of abdomen has the advantages of abundant bone volume,as well as soft tissue reconstruction in one stage.The reconstructed mandible can attain normal function and appearance.