3D打印技术辅助个性化钛网联合颊脂垫和前臂皮瓣修复上颌骨缺损

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1673 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探讨3D打印技术辅助预成形个性化的钛网联合颊脂垫及前臂皮瓣修复上颌骨缺损的效果。方法：选取2016年1月至2017年12月温州医科大学附属第一医院收治的7例上颌骨恶性肿瘤患者。术前制作3D模型并预成形钛网，术中植入钛网并联合颊脂垫和前臂皮瓣修复上颌骨缺损。结果：7例患者皮瓣均成活，完全封闭口鼻瘘，外形、语音、吞咽功能恢复效果令人满意，未出现肿瘤复发。结论：3D打印技术辅助的个性化钛网，联合颊脂垫和前臂皮瓣的“三明治”技术可以作为修复上颌骨缺损的一种选择。

	服务
	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	林崇翔
	屠呈威
	郑顺友

关键词 ：上颌骨, 缺损, 3D打印, 外科, 口腔, 修复重建

Abstract：Objective: To evaluate the clinical efficacy of maxillary reconstruction by individual titanium meshes based on 3D printed maxilla models, buccal-fat-pad flaps and free forearm flaps. Methods: Retrospective analysis of 7 cases with maxillary defects from January 2016 to December 2017 was made. A three-dimensional individual maxilla model based on mirror images of the unaffected maxilla was obtained to fabricate an anatomicallyadapted titanium mesh before operation. The individual titanium mesh was implanted after maxillectomy, together with the buccal-fat-pad flap and free forearm flap to reconstruct the maxilla. Results: All patients were satisfied with their postoperative facial symmetry. All flaps were alive, and closure of oral and nasal cavities as well as maxillary sinus was complete. All cases were able to eat through oral cavities, and their postoperative vocalization was clear. Conclusion: Individualized titanium meshes combined with buccal-fat-pad flaps and free forearm flaps to reconstruct maxillary defects can obtain satisfactory functional and aesthetic outcomes forpatients.

Key words： maxilla defect 3D printing technology surgery, oral reconstruction

收稿日期: 2018-01-02

基金资助:温州市科技局科研基金资助项目（Y2017076）。

通讯作者: 郑顺友，主任医师，Email：zhengshunyou2018@163.com。

作者简介: 林崇翔（1979-），男，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I6/429

[1] MüCKE T, HöLZLE F, LOEFFELBEIN D J, et al. Maxillary reconstruction using microvascular free flaps[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 111 (1): 51-57.
[2] PENG X, MAO C, YU G Y, et al. Maxillary reconstruction with the free fibula flap[J]. Plast Reconstr Surg, 2005, 115 (6): 1562-1569.
[3] BIANCHI B, FERRI A, FERRARI S, et al. Iliac crest free flap for maxillary reconstruction[J]. J Oral Maxillofac Surg, 2010, 68(11): 2706-2713.
[4] BIANCHI B, FERRI A, FERRARI S, et al. Iliac crest free flap and submental island flap for maxillary reconstruction [J]. J Plast Surg Hand Surg, 2013, 47(6): 538-542.
[5] 陈关福, 严君烈, 钟来平, 等. 带蒂颊脂垫衬里骨移植重建上颌骨的应用研究[J]. 中华整形外科杂志, 2003, 19(1): 5-7.
[6] 胡永杰, 张陈平. 应用钛网支架重建上颌骨肿瘤切除术后缺损畸形[J]. 上海口腔医学, 2002, 11(1): 28-31.
[7] LEE N. The Lancet Technology: 3D printing for instruments, models, and organs?[J]. Lancet, 2016, 388(10052): 1368.
[8] PASHUCK E T, STEVENS M. From clinical imaging to implantation of 3D printed tissues[J]. Nat Biotechnol, 2016, 34(3): 295-296.
[9] 张睿, 楼溢桯, 陈锴, 等. 3D打印技术在股骨髁间骨折治疗中的应用[J]. 温州医科大学学报, 2017, 47(6): 412-415.
[10] BROWN J S, ROGERS S N, MCNALLY D N, et al. A modified classification for the maxillectomy defect[J]. Head Neck, 2000, 22(1): 17-26.
[11] SAKURABA M, KIMATA Y, OTA Y, et al. Simple maxillary reconstruction using free tissue transfer and prostheses[J]. Plast Reconstr Surg, 2003, 111(2): 594-598.
[12] ILANKOVAN V, RAMCHANDANI P, WALJI S, et al. Reconstruction of maxillary defects with serratus anterior muscle and angle of the scapula[J]. Br J Oral Maxillofac Surg, 2011, 49(1): 53-57.
[13] AHMED D K, LI Z, LI Z B. Temporalis muscle flap for immediate reconstruction of maxillary defects: review of 39 cases[J]. Int J Oral Maxillofac Surg, 2011, 40(7): 715-721.
[14] MILES B A, GILBERT R W. Maxillary reconstruction with the scapular angle osteomyogenous free flap[J]. Arch Otolaryngol Head Neck Surg, 2011, 137(11): 1130-1135.
[15] NIU X G, ZHAO Y M, HAN X X. Multiplanar and combined distraction osteogenesis for three-dimensional and functional reconstruction of unilateral large maxillary de-fects[J]. Br J Oral Maxillofac Surg, 2009, 47(2): 106-110.
[16] TIDEMAN H, BOSANQUET A, SCOTT J. Use of the buccal fat pad as a pedicled graft[J]. J Oral Maxillofac Surg, 1986, 44(6): 435-440.
[17] TOSHIHIRO Y, NARIAI Y, TAKAMURA Y, et al. Applicability of buccal fat pad grafting for oral reconstruction[J]. Int J Oral Maxillofac Surg, 2013, 42(5): 604-610.
[18] SáNDOR G K, TUOVINEN V J, WOLFF J, et al. Adipose stem cell tissue-engineered construct used to treat large anterior mandibular defect: a case report and review of the clinical application of good manufacturing practice-level adipose stem cells for bone regeneration[J]. J Oral Maxillofac Surg, 2013, 71(5): 938-950.
[19] MESIMäKI K, LINDROOS B, TöRNWALL J, et al. Novel maxillary reconstruction with ectopic bone formation by GMP adipose stem cells[J]. Int J Oral Maxillofac Surg, 2009, 38(3): 201-209.