Mandibular Reconstruction With Iliac Crest Free Flap, Nasolabial Flap, and Osseointegrated Implants
Mandibular Reconstruction With Iliac Crest Free Flap, Nasolabial Flap, and Osseointegrated Implants
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DOI：
10.1016/j.joms.2014.02.031
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发表时间：
2014-06-01
影响因子：
1.9
通讯作者：
Navarro Vila, Carlos
中科院分区：
文献类型：
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作者：
Navarro Cuellar, Carlos;Ochandiano Caicoya, Santiago Jose;Navarro Vila, Carlos
目的：肿瘤患者行下颌骨节段切除术和软组织切除术后会出现一些美学和功能后遗症，因此，必须立即重建缺损。髂嵴皮瓣是唯一的皮瓣，允许重建以前的尺寸的下颌骨。然而，过多的软组织，这皮瓣防止最佳的重建口内软组织deficiency.Materials和方法：这份报告介绍了一种重建技术，用于12例谁接受了节段性下颌骨切除术，因为软组织缺损造成的肿瘤切除术。该技术涉及重建下颌骨使用髂嵴皮瓣结合鼻唇沟皮瓣，使随后重建的口内软组织和立即放置的骨整合implants.Results：骨整合成功率为95.2%，失败率为4.8%。失败尤其影响了受辐射的患者。髂骨游离皮瓣、鼻唇沟皮瓣和骨结合牙种植体均获得了良好的功能和美学效果。一方面，它能够重建下颌骨的原始尺寸，从而允许将种植体立即放置在理想的位置，以便随后使用假牙进行康复。另一方面，鼻唇沟皮瓣提供了一个薄层的组织，可以用来重建解剖的口下颌软组织。(C)2014年美国口腔颌面外科医师协会
Purpose: Oncologic patients undergoing segmental mandibulectomy with soft tissue resection develop several esthetic and functional sequelae; therefore, the defect must be reconstructed immediately. The iliac crest flap is the only flap that allows reconstruction of the previous dimensions of the mandible. However, the excessive soft tissue of this flap prevents optimal reconstruction of intraoral soft tissue defects.Materials and Methods: This report describes a reconstructive technique used in 12 patients who underwent segmental mandibulectomy because of soft tissue defects resulting from tumor resection. The technique involves reconstruction of the mandible using an iliac crest flap combined with a nasolabial flap to enable subsequent reconstruction of the intraoral soft tissue and immediate placement of osseointegrated implants.Results: The osseointegration success rate was 95.2% with a failure rate of 4.8%. Failure particularly affected the irradiated patients. Excellent functional and aesthetic results were obtained with the iliac crest free flap, nasolabial flap and osseointegrated dental implants.Conclusions: This technique has several advantages. On the one hand, it enables reconstruction of the original dimensions of the mandible, thus allowing immediate placement of implants in an ideal position for subsequent rehabilitation with a dental prosthesis. On the other hand, the nasolabial flap provides a thin layer of tissue that can be used to reconstruct the anatomy of the oromandibular soft tissue. (C) 2014 American Association of Oral and Maxillofacial Surgeons