Application of vascularized iliac flap and fibular flap in mandibular defect repair: a comparative study
10.3760/cma.j.issn.1671-0290.2023.05.005
- VernacularTitle:血管化髂骨瓣与腓骨瓣修复下颌骨缺损的比较研究
- Author:
Ning GAO
1
;
Kun FU
;
Jinghua CAI
;
Wei HE
Author Information
1. 郑州大学第一附属医院口腔颌面外科，郑州 450052
- Keywords:
Ameloblastoma;
Dental implantation;
Mandible;
Ilium;
Fibula;
Quality of life
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2023;29(5):364-368
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To provide theoretical guidance for the treatment of mandibular ameloblastoma by comparing the differences in the quality of life (QOL) of patients with mandibular ameloblastoma repaired by vascularized iliac bone flap and fibular flap.Methods:Seventy-two patients with mandibular ameloblastoma were admitted to the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Zhengzhou University from August 2016 to April 2019. There were 38 males and 34 females, aged 18-45 years, with an average of 33 years. The patients were divided into group A (iliac bone flap) with 28 cases and group B (fibula skin flap) with 44 cases. The 14-item Oral Health Impact Profile questionnaires (OHIP-14) was used to investigate and compare the differences in the QOL of patients 6 and 24 months after surgery.Results:All the 72 cases of free flaps survived. The OHIP-14 showed that there was no difference in physiological pain between the preoperative and postoperative levels ( P>0.05). There was no difference between the two groups. The scores of psychological discomfort and psychological disorder decreased at 24 months after surgery, without significantly statistical difference compared with that at 6 months after surgery ( P>0.05). The scores of physical impairment, disability and social impairment significantly reduced at 24 months after surgery, with significantly statistical difference compared with that at 6 months after surgery (iliac bone group t=8.07, 6.01 and 23.19; fibula group t=6.56, 4.27 and 13.01, P<0.05). The scores of functional limitations significantly reduced in both groups at 24 months after surgery, but the difference was still statistically significant ( t=2.30, P<0.05) between the iliac bone group (17.68±3.44) and the fibula group (22.70±11.19). Conclusions:There is no significant difference in the QOL between the two groups of patients with mandibular defects at 24 months after surgery. The application of iliac bone flapis is recommended for patients with mandibular body defects and fibular flap for large defects or lesions involving the condyles and chin.
