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目的评价游离游离前臂皮瓣、颊脂垫修复上颌骨缺损的临床效果。方法根据上颌骨切除后的修复方式分为两组:手术组10例,即上颌骨切除后立即行游离游离前臂皮瓣、颊脂垫修复的患者;赝复体组10例,即上颌骨切除后未行修复,术后佩戴赝修复体的患者。通过鼻咽纤维镜检查、语音清晰度测试、咀嚼效率测量,对两组患者在语言、咀嚼、腭咽闭合方面行功能性评价。结果手术重建组咀嚼效率75%～95%,平均82.5%,赝复体组咀嚼效率为50%～82%,平均64.5%,两组差异有统计学意义(P<0.05);手术组语音清晰度94%～96%,平均95.2%,赝复体组语音清晰度70%～86%,平均79.5%,两组差异有统计学意义(P<0.05);手术组完全性腭咽闭合率是90%,赝复体组为零,两组差异有统计学意义(P<0.05)。结论用游离前臂皮瓣、颊脂垫修复上颌骨缺损较传统修复方法更有效地恢复上颌骨功能和结构,是上颌骨缺损修复的良好选择。
Objective To evaluate the clinical effect of free free forearm flap and buccal fat pad to repair maxillary defect. Methods According to the way of repair after maxillary excision, the patients were divided into two groups: operation group (n = 10), patients with free forearm flap and buccal fat pad immediately after maxillary resection; prosthesis group (n = 10) After no repair, postoperative prosthetic prosthesis patients. Through the nasopharyngeal fiberoscopy, speech intelligibility test, masticatory efficiency measurement, the functional evaluation of the two groups in language, chewing, velopharyngeal closure. Results The mastication efficiency of operation reconstruction group was 75% -95% with an average of 82.5%. The chewing efficiency of prosthesis group was 50% -82% with an average of 64.5%. There was significant difference between the two groups (P <0.05) The degree of complete velopharyngeal closure in the operation group was 94% ~ 96%, with an average of 95.2%. The speech clarity of the prosthesis group was 70% ~ 86% with an average of 79.5% (P <0.05) 90%, prosthetic group was zero, the difference between the two groups was statistically significant (P <0.05). Conclusion The repair of maxillary defect with free forearm flap and buccal fat pad can restore maxillary function and structure more effectively than traditional repair method. It is a good choice for repairing maxillary defect.