Reconstruction of combined oral mucosa-mandibular defects using the vascularized myoosseous iliac crest free flap.
Reconstruction of combined oral mucosa-mandibular defects using the vascularized myoosseous iliac crest free flap.
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DOI：
10.7314/apjcp.2012.13.8.4137
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Hwi-Dong Jung;W. Nam;I. Cha;Hyung Jun Kim
中科院分区：
文献类型：
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作者：
Hwi-Dong Jung;W. Nam;I. Cha;Hyung Jun Kim
作者报告了5例应用带血管蒂的内眦髂嵴肌骨瓣游离移植修复口腔粘膜-下颌骨联合缺损的病例。与其他传统方法（例如桡骨瓣、肩胛骨瓣和腓骨瓣）相比，该技术具有许多优点。带血管蒂的髂嵴瓣可提供足够的优质骨，适用于修复下颌骨节段性缺损。虽然腓骨瓣允许获取更长的供体骨组织，但髂嵴可以为下颌骨体重建提供美学形状，并且还为牙科植入物提供足够的骨高度。传统的带血管蒂的髂嵴肌骨瓣在重建口内软组织缺损时存在软组织体积过大的问题。本文所讨论的改良可以减少软组织体积，从而更好地重建口腔粘膜的功能。另一个优点是，早在术后一个月就可以观察到口腔粘膜的完全替换。最终的粘膜质地比其他皮桨瓣更好，这对牙种植修复体的放置特别有利。在功能和美学方面，供体部位发病率与其他模式相似（如果不低于其他模式）。对于口腔粘膜-下颌骨联合缺损，带血管蒂的内眦髂嵴肌骨游离皮瓣修复软硬组织缺损效果良好。
The authors present five cases of combined oral mucosa-mandible defects reconstructed with the vascularized internal oblique-iliac crest myoosseous free flap. This technique has many advantages compared to other conventional methods such as the radial flap, scapula flap, and fibula flap. Vascularized iliac crest flaps provide sufficient high-quality bone suitable for reconstructing segmental mandibular defects. Although fibular flaps allow longer donor bone tissue to be harvested, the iliac crest can provide an esthetic shape for mandibular body reconstruction and also provides sufficient bone height for dental implants. Conventional vascularized iliac crest myoosseous flaps have excessive soft tissue bulk for reconstruction of intraoral soft tissue defects. The modification discussed in the present article can reduce soft tissue volume, resulting in better functional reconstruction of the oral mucosa. Another advantage is that complete replacement of the oral mucosa is observed in as early as one month post-operation. The final mucosal texture is much better than that obtained with other skin paddle flaps, which is especially beneficial for the placement of dental implant prostheses. Donor site morbidity looks to be similar to, if not less than that observed for other modalities in terms of function and esthetics. For combined oral mucosa-mandible defects, the vascularized internal oblique-iliac crest myoosseous free flap shows good results with respect to hard and soft tissue reconstruction.