- 期刊
後天性上顎缺損之重建－手術修補或閉孔器
Acquired Maxillay Defect-Surgical Reconstruction of Obturator
摘要
造成上顎缺損主要原因為口腔惡性腫瘤侵犯至上顎區周圍，經手術切除後產生。上顎缺損會導致吞嚥、咀嚼及發音功能異常。上顎缺損修補方式主要為島瓣手術修補或以閉孔器修補，至於如何選擇此兩種修補方式，一直是爭論之焦點。本文統計59位上顎缺損之患者，其中40位接受閉孔器修補，19位接受手術修補。結果顯示閉孔器修補，大多使用在切除較晚期之口腔癌、顏面槍彈傷及上顎骨放射性骨壞死，所造成之上顎缺損，及年齡較大之患者，比例上男性比女生高。而手術修補大多使用在較早期之口腔癌及口腔良性腫瘤切除之患者，比例上女性比男性高。上顎缺損範圍在上顎半切除以下，使用閉孔器及手術修補，皆能得到良好術後發音功能異常矯治之效果。如手術切除範圍深至軟腭後緣，閉孔器則比手術修補到得到較好矯治發音異常之效果。
並列摘要
Most patient who have acquired maxillary defects suffer from dysfunction of deglutition, mastication and speech. Those maxillary defect may be restored by surgical reconstruction or by prosthetic rehabiliation with obturator. It is a continuing debate on the most appropriate methods of reconstruction for patient. 59 patients who have acquired maxillary defects most resulted from extensive oral cancer serves as the subjects. 40 cases who reconsruction with obturator and 19 cases who reconstruction with different flap repair. The speech of each case was evaluated either before and after surgery in those treat with flap repaired or with obturator mangement may best be applied on extensiveoral cancer, gun shot injury and osteoradionecrosis of maxilla. Most surgical repair used in early oral cancer and benign tumor resection, placement of an obturator or surgical closure can improve the speech of most patients who have maxillary defects below hemirnaxillectomy. The patient who had large defect extending into psterior edge of soft palate obtains better restoration of speech and function from obturator management rather than surgical reconsturction.