口腔颌面肿瘤手术中医学美学原则的应用

The application of aesthetic principle in the surgical operation of oral maxillofacial tumor surgery

目的:研究医学美学原则在口腔颌面良性肿瘤、恶性肿瘤治疗中的具体应用,讨论应用医学美学原则对提高口腔颌面肿瘤患者手术治疗后生存质量的作用。方法:2004～2007年,口腔颌面部手术患者67例,36例良性肿瘤患者包括:颌骨囊肿,成釉细胞瘤,腮腺良性肿瘤,腮腺脉管畸形,鳃裂囊肿等;31例恶性肿瘤患者包括:唇癌、舌癌、口底癌、上颌窦癌、恶性淋巴瘤等。笔者结合患者对手术医学美学方面的要求,应用美容医学原则进行具体手术设计、手术实施。结果:下颌骨体部囊肿患者,可从口内入路手术,也可采用袋形手术,不截骨、植骨,面部不遗留手术瘢痕。青年单房性的成釉细胞瘤患者,可行瘤体扩大切除,也可加微波热凝处理,不做截骨。腮腺良性肿瘤患者,手术切口选择面部隐蔽部位,缝合皮肤时,采用美容外科缝合方法。恶性肿瘤患者,在切除肿瘤后的修复时,应考虑到面部外形的恢复,如唇癌切除后,应用唇颊侧滑行皮瓣修复组织缺损,不破坏对侧唇的组织结构。上颌窦癌上颌骨切除后的眶底重建,应考虑到上颌骨、颧骨的外形突起,恢复个体面部外形;手术后采用临时赝复体,及时恢复面部外形。恶性肿瘤切除后软组织皮瓣修复时,供区组织切取后的外形障碍也应予以考虑。颈部淋巴瘤活检手术时,选择侧颈部隐蔽部位等。结论:在口腔颌面-头颈肿瘤外科手术中应用医学美学原则,可以减少手术带来的对口腔颌面部外形、功能的破坏,提高患者手术后的生活质量。

Objective To study the application of medical aesthetic principle in the oral and maxillofacial surgical operations of benign tumor, malignant tumor. Methods 2004 N2007 years, the 67 cases of oral and maxillofacial surgical operations, 36 benign tumor cases include： Odontogenic cyst,ameloblastoma, vascular malformation in parotid and parotid benign tumor, branchial cleft cyst. 31 malignant tumor cases include carcinoma of the lip, carcinoma of the tongue carcinoma of the maxillary sinus malignant lymphoma etc. Combine the patient＇s aesthetic request to the surgical operation, apply the medical aesthetic principle to carry on a surgical operation design. Results Build up various opposite methods correspond of medical aesthetic principle with concrete surgical operation design with receive an implement method. Conclusions Applied medical aesthetics in the oral and maxillofacial surgical operations, can raise patients postoperative living quality, reduce surgical operation to bring of to the breakage of oral and face shape and function.