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大口の欠陥の再構築: シングル・キメリック・ソラコドラル動脈フラップとスカプル対ダブル・フリーフラップ
Xiao Tan1,2,3, Tao Rui1,2, Xianbei Zhu1,2
1Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University.
The Journal of craniofacial surgery
|August 22, 2025
まとめ
胸椎動脈のキメリック・フラップは,大腿骨と大背骨 (cTDAF-SLD) とともに,広範囲な口の欠陥の再建のための信頼性の高い解決策を提供します. このフラップは他の方法と比較して 機能的・美学的な成果を上げながら 複雑さとコストを大幅に削減します
科学分野:
- 整形 術
- 口腔・口腔外科
- 再建 術
背景:
- 骨と柔らかい組織の両方を必要とする広範な複合的な欠陥の復元は,重要な外科的課題を提示します.
- 大型口の欠陥に対する包括的な選択肢として,肩骨と背 (cTDAF-SLD) とのキメリック胸動脈のフラップが導入されます.
研究 の 目的:
- オロマンディブル再建におけるcTDAF-SLDフラップの効果と結果を評価する.
- cTDAF-SLDフラップとフィブラーフラップと前側大腿フラップ (SCFAF) の同時組み合わせを比較する.
主な方法:
- 骨下部を侵食する口腔がんを患った患者29人を対象とした比較研究.
- cTDAF- SLD (n=18) またはSCFAF (n=11) を使用して再構築を行った.
- 評価されたアウトカムには,手術後の変数,機能的および美学的な結果 (VAS,UW-QOL),および飲み機能が含まれていた.
主要な成果:
- cTDAF- SLDグループは,SCFAFグループと比較して,手術の時間,血流,入院,排水,および費用を大幅に削減しました (P < 0. 05).
- 2つのグループでは,機能的または美学的な結果の有意な違いは見つかりませんでした.
- SCFAFグループは,受容体とドナー部位における合併症の有意に高い発生率 (P < 0. 05) を経験した.
結論:
- 骨格のキメリックTDAFは,広範囲の口欠陥を再構築するための信頼性の高い効果的な方法です.
- 同時にダブルフリーフラップに匹敵する機能的・美学的な結果が得られます.
- このテクニックは,全体的な合併症を減らすのに重要な利点を提供します.
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