颞肌瓣加预制钛网复合松质骨Ⅰ期重建上颌骨缺损

The immediate and functional maxillary reconstruction with temporalis muscle flap and prefabricated titanium mesh combined with iliac cancellous bone

目的:探讨上颌骨肿瘤切除后面部缺损的功能及外形修复方法。方法:回顾分析1999～2003年我科因肿瘤行上颌骨全切术或次全切除术的患者共8例,所有患者均行颞肌瓣加预制钛网复合松质骨Ⅰ期上颌骨重建。术前制作上颌骨缺损区的钛网支架,肿瘤切除后即刻植入,充填髂骨骨松质,并以颞肌瓣包裹重建上颌骨。结果:所有8例患者,术后面部外形满意,发音正常,颞肌瓣生长良好,钛网固定稳定。结论:用颞肌瓣及钛网修复上颌骨缺损,方法简便,手术切口隐蔽,对颌面部塌陷畸形、口鼻腔穿通造成的发音进食障碍,一次手术即可达到较满意的修复效果。

Objective To explore the applied technology for immediate functional and formal maxillary reconstruction after maxilloectomy. Methods 8 cases were retrospectively observed from 1999 to 2003.Patients of maxilla tumors were received maxilloectomy and immediate maxillary reconstruction with titanium meshes and temporalis muscle flaps.The prefabricated titanium mesh according to the defect was immediately implanted after tumor resection.The mesh was tightly filled with iliac cancellous bone.The wound was covered with temporalis muscle flap. Results All of flaps were survived and titanium meshes were well fixed without complications during the follow-up. The appearance and function were reconstruced successfully. Conclusion The immediate maxillary reconstruction with temporalis muscle flap and prefabricated titanium mesh combined with iliac cancellous bone is a better methods treating maxillart defect with simpleness and lower complications.The function and appearences were satisfactory with this method.