血管化腓骨瓣修复二膦酸盐颌骨骨坏死导致的下颌骨缺损:病例报告及文献复习

Vascularized fibula flap reconstruction of the mandible defect resulting from bisphosphonate-related osteonecrosis of the jaws: case report and literature review

二膦酸盐(Bisphosphonates,BPs)作为一种强效骨吸收作用抑制剂已经用于临床30多年,广泛用于控制与骨更新改变相关的疾病。近年来发现,临床长期应用二膦酸盐类药物可导致颌骨骨坏死。对于二膦酸盐颌骨骨坏死的治疗,学术界观点不一,包括保守治疗、手术刮治、颌骨切除(重建或不重建)。本文介绍1例采用血管化腓骨瓣修复二膦酸盐颌骨骨坏死造成的下颌骨缺损,效果满意。

Bisphosphonates have been used in clinic for over 30 years as a potent of bone resorption inhibitors, which are widely prescribed in diseases related to bone turnover change. In recent years, many authors found that long-term application of bisphosphonates can lead to osteonecrosis of the jaws. The treatment proposal has not reached consensus,including conservative treatment, surgical curettage and bone resection（reconstruction or without reconstruction）. This paper reported a case with mandibular defect resulting from bisphosphonate related osteonecrosis of the jaws, repaired with vascularized fibular flap subsequently. The final functional and aesthetic outcomes were satisfied.