游离腓骨肌皮瓣及CT血管造影术在下颌骨缺损重建中的应用

Application of free fibular flap and computed tomographic angiography in the reconstruction of mandibular defects

目的:探讨游离腓骨肌皮瓣及CT血管造影(CTA)技术在重建下颌骨缺损中应用。方法:10例下颌骨术后缺损拟行游离腓骨肌皮瓣重建,术前常规行下肢CTA检查,重建钛板预成形,进行游离腓骨肌皮瓣下颌骨重建。结果:术前CTA检查顺利,10例中1例胫后动脉缺如,腓动脉代替胫后动脉,放弃腓骨肌皮瓣重建。9例游离腓骨肌皮瓣均成活(成功率100%),下颌骨外形及功能满意。结论:腓骨肌皮瓣可提供足够软、硬组织量,是下颌骨复合缺损修复的较好供体;CTA技术在游离腓骨肌皮瓣重建下颌骨缺损术前供区评价选择、手术设计等方面具有很好的应用价值。

Objective：To study the feasibility of application of free fibular flap and computed tomographic angiography（CTA） in the reconstruction of mandibular defects.Methods：10 cases of mandibular defect were enrroled in this study.Before operation patient＇s lower extremity vasculture was examined by CTA.Titanium board for defect repair was shaped preliminarily during mandible reconstruction.Results：Preoperative CTA examination was carried out without complication in all patients.In one of the 10 cases fibular flap was not used because posterior tibial atery was absent and substituted by fei atery.In other 9 cases free fibular flap was applied to repair the mandible defects.All the flaps were living,and all the shape and function of mandible were satisfactory after operation.Conclusion：Fibular flap can provide enough soft and sclerous tissue for mandible reconstruction.CTA may provide valuable data of blood supply for selection of donor site,shaping of fibula flap and planning of operation.