下顎複合組織欠損の再建に関する臨床統計的研究

概要

論文の詳細を見る
As a result of the development of reconstructive surgery in the head and neck using various flaps, radical operation for a malignant disease has facilitated, and therapeutic results have remarkably improved. Forty-one patients who underwent reconstruction of the composite mandibular defect in our clinic for the past nine years were reviewed, and the results were as follows. 1. Thirty patients were reconstructed using a pectoralis major myocutaneous (PMMC) flap combined with an A-O reconstruction plate (19 cases), an almina ceramic implant (2 cases), or without mandibular reconstruction (9 cases), one using a rib-latissimus dorsi osteomyocutaneous flap, and ten using a free vascularized composite graft. 2. In reconstruction with a PMMC flap, flap survival rate was 90% and satisfactory results were obtained as to reconstruction of the soft tissue. Disadvantages of a PMMC flap are mainly bulk and limitation of the flap rotation. As to mandibular reconstruction, on the other hand, about one third of the cases had complications such as loosening of fixative devices, exposure or breakage of the implant. 3. In reconstruction with a free vascularized composite flap, a radial forearm flap with hemi-radius was indicated in a marginal mandibulectomy, and a vascularized fibular graft with skin in a segmental mandibulectomy. 4. Free vascularized composite grafts gave better results than PMMC flaps, especially in mandibular reconstruction because of less resorption and infection. However, indications of free flaps should be carefully considered, especially in patients who have systemic diseases and those who are older than 65 years old because the result is all or none.

下顎複合組織欠損の再建に関する臨床統計的研究

スポンサーリンク

概要

著者

関連論文

スポンサーリンク