上颌骨切除术后组织缺损的修复

Reconstruction for maxillofacial defect in paranasal sinus neoplasm dissection

目的:探讨上颌骨切除术后组织缺损修复的方法。方法:回顾分析4 5例鼻窦肿瘤行上颌骨切除,即刻用全额肌皮瓣、颞肌皮瓣、胸大肌皮瓣等修复组织缺损患者的临床资料。结果:成功4 1例,切口一期愈合,无明显并发症,全部转移瓣存活,血供良好。皮瓣部分坏死4例,移植组织瓣边缘坏死,创面延期愈合。结论:完整上颌骨切除仅有硬腭缺损可用赝复体修复,眶周及上颌骨的上部切除选择颞肌皮瓣,全额肌皮瓣修复,下部切除可选择局部皮瓣或黏膜瓣修复;眶底缺损选择颞肌区域性皮瓣、全额肌皮瓣较好。

Objective： To explore the resconstrutive option for maxillary defect. Method： A retrospective analysis was applied. Forty- five consecutive patients were included who underwent surgical revision of paranasal sinus neoplasm dissection form March, 1983 to December, 2000. Result：Forty - one cases underwenting surgical revision with all kinds of flap were alive, and 4 cases had partial necrosis. The function of breath through nose or mouth , deglutition and speech were satisfactory. Conclusion：The forehead flap and the temporalis regional flap are particular useful in the surgical revision of posterior and superior partial maxillary defect with associated sino - orbital or soft tissue deficits . The regional flap and prosthesis may provide an ideal option to the complete maxillectomy.