■由于使用抑制骨转移的药物,与药物相关的颌骨坏死(MRONJ)的发生率和患者人数急剧增加。然而,其临床治疗仍然非常困难。这项研究的目的是评估下颌骨MRONJ即刻腓骨皮瓣重建的有效性和结果。
■从1990年至2022年在我们机构接受了MRONJ下颌骨即刻腓骨皮瓣重建的患者进行了筛查和鉴定。他们的人口统计,药物史,症状,收集并分析手术参数和随访数据.
■总共,包括25例MRONJ3期患者。给药的主要原因是骨转移(88%),唑来膦酸盐是主要药物。疼痛,肿胀(44%),脓溢(28%),口外瘘(16%)和坏死骨暴露(12%)是主要的主诉。下颌骨节段切除术后,腓骨皮瓣收获9.73±3.37cm,将18/25(72%)切成两段以重建下颌骨。68%的人放置了口内皮肤桨。所有的皮瓣都活了下来,和21/25(84%)的软组织进行了初步愈合。随访期间,症状的缓解是有效的,没有原发疾病进展或死亡。
■这是下颌骨MRONJ腓骨皮瓣重建的最大的全面研究,这被证明是管理MRONJ晚期患者的一种替代和有效的治疗方法。
UNASSIGNED: The incidence and patient population of medication-related osteonecrosis of the jaw (MRONJ) has dramatically increased due to the use of drugs suppressing bone metastasis. However, its clinical treatment is still very difficult. The aim of this study was to evaluate the effectiveness and outcome of immediate fibular flap reconstruction for MRONJ in the mandible.
UNASSIGNED: Patients who underwent immediate fibular flap reconstruction for MRONJ in the mandible in our institution from 1990 to 2022 were screened and identified. Their demographics, drug history, symptoms, surgical parameters and follow-up data were collected and analyzed.
UNASSIGNED: In total, 25 patients with MRONJ stage 3 were included. The main cause of drug administration was osseous metastasis (88%), and zoledronate was the main drug. Pain, swelling (44%), pyorrhea (28%), extraoral fistulas (16%) and necrotic bone exposure (12%) were the main chief complaints. After segmental mandibulectomy, the fibular flap harvest was 9.73 ± 3.37 cm, and 18/25 (72%) were cut into two segments to reconstruct the mandible. Sixty-eight percent had an intraoral skin paddle placed. All of the flaps survived, and 21/25 (84%) of the soft tissue underwent primary healing. During follow-up, the alleviation of symptoms was effective, and there was no primary disease progression or death.
UNASSIGNED: This is the largest comprehensive investigation of fibular flap reconstruction for MRONJ in the mandible, which is proved to be an alternative and effective treatment for managing advanced patients with MRONJ.