Abstract：
OBJECTIVE: The maxillectomy defect is complex and the best means to achieve optimal reconstruction, and dental rehabilitation is a source of debate. The refinements in zygomatic implant techniques have altered the means and speed by which rehabilitation can be achieved and has also influenced the choice regarding ideal flap reconstruction. The aim of this study is to report on how the method of reconstruction and oral rehabilitation of the maxilla has changed since 1994 in our Institution, and to reflect on case mix and survival.
METHODS: Consecutive head and neck oncology cases involving maxillary resections over a 27-year period between January 1994 and November 2020 were identified from hospital records and previous studies. Case note review focussed on clinical characteristics, reconstruction, prosthetic rehabilitation, and survival.
RESULTS: There were 186 patients and the tumour sites were: alveolus for 56% (104), hard palate for 19% (35), maxillary sinus for 18% (34) and nasal for 7% (13). 52% (97) were Brown class 2 defects. Forty-five patients were managed by obturation and 78% (142/183) had free tissue transfer. The main flaps used were radial (52), anterolateral thigh (27), DCIA (22), scapula (13) and fibula (11). There were significant changes over time regarding reconstruction type, use of primary implants, type of dental restoration, and length of hospital stay. Overall survival after 24 months was 64% (SE 4%) and after 60 months was 42% (SE 4%).
CONCLUSIONS: These data reflect a shift in the reconstruction of the maxillary defect afforded by the utilisation of zygomatic implants.
METHODS: Consecutive head and neck oncology cases involving maxillary resections over a 27-year period between January 1994 and November 2020 were identified from hospital records and previous studies. Case note review focussed on clinical characteristics, reconstruction, prosthetic rehabilitation, and survival.
RESULTS: There were 186 patients and the tumour sites were: alveolus for 56% (104), hard palate for 19% (35), maxillary sinus for 18% (34) and nasal for 7% (13). 52% (97) were Brown class 2 defects. Forty-five patients were managed by obturation and 78% (142/183) had free tissue transfer. The main flaps used were radial (52), anterolateral thigh (27), DCIA (22), scapula (13) and fibula (11). There were significant changes over time regarding reconstruction type, use of primary implants, type of dental restoration, and length of hospital stay. Overall survival after 24 months was 64% (SE 4%) and after 60 months was 42% (SE 4%).
CONCLUSIONS: These data reflect a shift in the reconstruction of the maxillary defect afforded by the utilisation of zygomatic implants.
摘要：
目的：上颌切除缺损复杂，是实现最佳重建的最佳手段，牙科康复是一个争论的源头。the骨植入技术的改进改变了实现康复的手段和速度，也影响了理想皮瓣重建的选择。这项研究的目的是报告自1994年以来，上颌骨的重建和口腔康复方法如何改变。并反思案例组合和生存。
方法：在1994年1月至2020年11月的27年间，从医院记录和以前的研究中发现了涉及上颌骨切除术的连续头颈部肿瘤病例。病例记录回顾集中于临床特征，重建,假肢康复,和生存。
结果：有186例患者，肿瘤部位为：肺泡占56％（104），硬腭占19%(35)，上颌窦占18％（34），鼻为7％（13）。52%(97)为棕色2类缺陷。45例患者接受闭塞治疗，78％（142/183）的组织游离转移。使用的主要襟翼是径向的（52），大腿前外侧(27),DCIA(22),肩胛骨（13）和腓骨（11）。随着时间的推移，重建类型发生了重大变化，使用初级植入物，牙齿修复的类型，和住院时间。24个月后的总生存率为64％（SE4％），60个月后的总生存率为42％（SE4％）。
结论：这些数据反映了通过使用zy骨植入物提供的上颌骨缺损重建的转变。
方法：在1994年1月至2020年11月的27年间，从医院记录和以前的研究中发现了涉及上颌骨切除术的连续头颈部肿瘤病例。病例记录回顾集中于临床特征，重建,假肢康复,和生存。
结果：有186例患者，肿瘤部位为：肺泡占56％（104），硬腭占19%(35)，上颌窦占18％（34），鼻为7％（13）。52%(97)为棕色2类缺陷。45例患者接受闭塞治疗，78％（142/183）的组织游离转移。使用的主要襟翼是径向的（52），大腿前外侧(27),DCIA(22),肩胛骨（13）和腓骨（11）。随着时间的推移，重建类型发生了重大变化，使用初级植入物，牙齿修复的类型，和住院时间。24个月后的总生存率为64％（SE4％），60个月后的总生存率为42％（SE4％）。
结论：这些数据反映了通过使用zy骨植入物提供的上颌骨缺损重建的转变。
