口腔颌面外科杂志2024，Vol.34Issue(2)：129-133,5.DOI:10.12439/kqhm.1005-4979.2024.02.008
单侧腓骨皮瓣重建鼻咽癌患者放疗术后双侧下颌骨放射性颌骨坏死
Bilateral radiating osteoradionecrosis of the mandible after radioterapy in patients with nasopharyngeal carcinoma with unilateral fibular flap reconstruction
摘要
Abstract
Objective:To investigate the effect of fibular free flap on reconstruction of postoperative defects after radiation-induced bilateral osteoradionecrosis of the jaw(ORNJ).Methods:Seven patients with radiation ORNJ who were referrd to Department of Oral and Maxillofacial Surgery in our hospital from January 2010 to November 2020 were retrospected.Among the cases,6 males and 1 female,aged 42 to 56 years old,were included.All patients had primary nasopharyngeal carcinoma,and recurrent nasopharyngeal carcinoma was excluded.Fibular free flap was used to reconstruct bilateral osteoradionecrosis of the mandible.The fibular osteotomy and tissue flap survival,complications in donor and recipient areas,and postoperative mouth opening were evaluated for reconstruction outcomes.Results:After 10 to 30 months of follow-up,free fibular composite flap was successfully used to reconstruct mandibular defects.Facial artery was selected in 5 cases,superior thyroid artery in 2 cases,and end-to-side anastomosis of internal jugular vein was performed in all recipient veins.One patient developed venous crisis 6 hours after surgery.Emergency surgical exploration revealed that the vein was twisted during end-to-side anastomosis and recovered well after re-anastomosis.The harvested fibula was 17.5-21.0 cm in length.No patient had serious donor or recipient site complications.All patients had satisfactory facial shape,remaining normal occlusion,and mouth opening was 2.5-3.3 cm.Conclusion:Fibular myocutaneous flap can reconstruct the bilateral mandibular soft and hard tissue defects after radiation in patients with ORNJ,which is worthy of clinical application.关键词
下颌骨/放射性骨坏死/腓骨肌皮瓣/鼻咽癌Key words
mandible/osteoradionecrosis of the jaw/fibular osteocutaneous flap/nasopharyngeal carcinoma分类
医药卫生引用本文复制引用
彭勇淳,段红明,吴汉江,张胜,范腾飞..单侧腓骨皮瓣重建鼻咽癌患者放疗术后双侧下颌骨放射性颌骨坏死[J].口腔颌面外科杂志,2024,34(2):129-133,5.基金项目
国家自然科学基金(81802716) （81802716）
湖南创新型省份建设专项(2020JJ5804) （2020JJ5804）
湖南省卫生健康委科研计划课题项目(C2019163) （C2019163）
电磁辐射医学防护教育部重点实验室2018年度开放课题(2018DCKF003) （2018DCKF003）
