Abstract：
The functional restoration of Brown class III maxillary defects is a challenging endeavour in oral and maxillofacial surgery. Conventional reconstruction techniques with osseous free flaps have certain limitations, such as the need for multiple operations and greater patient morbidity. This study introduces a single-stage computer-assisted approach for tumour resection and functional restoration of these defects using titanium mesh, zygomatic implants, and a vascularized anterolateral thigh flap (ALTF). Virtual surgical planning was used to simulate tumour resection, titanium mesh placement, and zygomatic implant insertion. Surgery was performed under the guidance of mixed reality and surgical navigation. The tumour was resected by total hemimaxillectomy, and the reconstruction was performed using a pre-bent patient-specific titanium mesh for the orbital floor and two zygomatic implants placed and exposed through tunnels in an ALTF. The ALTF survived without any perioperative complications. A fixed prosthesis with built-in titanium frame was delivered 4 months postoperatively. At the 1-year follow-up, there was no tumour recurrence, the implants were osseointegrated, and aesthetics and masticatory function were satisfactory. An occlusal force of 155 N was attained on the reconstructed side, compared to 127 N on the non-surgical side.
摘要：
BrownIII类上颌骨缺损的功能修复在口腔颌面外科中是一项具有挑战性的工作。传统的骨游离皮瓣重建技术有一定的局限性,例如需要多次手术和更高的患者发病率。这项研究介绍了一种使用钛网进行肿瘤切除和功能恢复的单级计算机辅助方法，颧骨植入物,血管化股前外侧皮瓣(ALTF)。虚拟手术计划用于模拟肿瘤切除，钛网放置，和颧骨植入物插入。手术在混合现实和手术导航的指导下进行。肿瘤通过全半动脉切除术切除，重建是使用预先弯曲的患者特异性钛网进行的，用于眶底和两个通过ALTF中的隧道放置和暴露的zy骨植入物。ALTF存活，无任何围手术期并发症。术后4个月交付了带有内置钛框架的固定假体。在1年的随访中，没有肿瘤复发,植入物是骨整合的，美学和咀嚼功能令人满意。在重建侧获得了155N的咬合力，与非手术侧的127N相比。
