Reconstruction of Anterior Mandible and Mouth Floor Using the Myofascial Iliac Crest Free Flap After Tumor Resection

Reconstruction of Anterior Mandible and Mouth Floor Using the Myofascial Iliac Crest Free Flap After Tumor Resection
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肿瘤切除后游离肌筋膜髂嵴皮瓣重建下颌前牙及口底

DOI:
10.1097/sap.0000000000001649
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发表时间:
2019-04
影响因子:
1.5
通讯作者:
宋凯
宋凯
中科院分区:
医学4区
文献类型:
--
作者:
徐豪越;高策;陶月琴;杨小琛;尚伟;宋凯

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摘要本文介绍了一种应用髂嵴肌筋膜瓣游离移植修复下颌前牙及口底缺损的新方法。2015年5月至2017年7月期间就诊的4例患者均受益于该技术。此皮瓣的肌筋膜部分被设计为附着于髂嵴,并在确定神经血管蒂后获得皮瓣。我们将髂嵴以外向的方式转移到下颌骨缺损处作为牙槽突的基底。我们发现,髂嵴可以提供足够的骨高度和美学形状的重建前下颌骨。更重要的是,我们还观察到,早在术后1个月,皮瓣表面的肌筋膜成分就完全取代了口腔粘膜。此外,使用该方法可以获得适当的软组织体积,以更好地重建口腔粘膜的功能。在随访期间,没有观察到明显的肌筋膜瘢痕挛缩。髂嵴肌筋膜瓣是修复口腔黏膜-下颌骨联合缺损的理想方法。
Abstract The current study introduces a novel approach of anterior mandible and mouth floor reconstruction with the myofascial iliac crest free flap. A series of 4 patients who presented between May 2015 and July 2017 had benefited from this technique. The myofascial component of this flap was designed to be attached to the iliac crest, and the flap was obtained after identifying the neurovascular pedicle. We transferred the iliac crest, with an outward-oriented placement, to the mandibular defect as the base of the alveolar process. We found that the iliac crest can provide sufficient bone height and an aesthetic shape for the reconstruction of the anterior mandible. More important, we also observed that the myofascial component on the flap surface completely replaced the oral mucosa in as early as 1 month after the operation. Moreover, the proper soft tissue volume can be achieved using this approach for better functional reconstruction of the oral mucosa. No obvious scar contracture of the myofascial component was observed during the follow-up period. The myofascial iliac crest free flap could provide a suitable reconstruction method for combined oral mucosa–mandible defects.
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