- 期刊
使用游離頰脂肪墊填充藥物相關顎骨壞死之手術缺陷－病例報告
Free Buccal Fat Pad for Surgical Defect Filling of Medication Related Osteonecrosis of the Jaws (MRONJ)-A Case Report
摘要
對於藥物相關顎骨壞死治療而言，手術介入相對保守治療而言，提供較高癒合率，目前已成國際上治療主流。然而，如何處理腐骨清除後之骨缺損，仍然是具有挑戰性的問題。使用蒂狀頰脂肪墊來填充骨缺損已是目前常見，可提供良好效果之方法，但只受限使用於後上頜骨區。為了擴充頰脂肪墊的優點，我們嘗試一種新的治療方式，使用游離頰脂肪墊來填充上顎後部以外的骨缺損。本病例報告提出一位被診斷右下顎藥物相關骨壞死的82歲女性，進行腐骨清除術及骨造碟術，並使用游離頰脂肪墊皮瓣來填充手術缺損，回診觀察期間傷口癒合良好，組織外觀也無明顯凹陷。依據此病例成功治療經驗，游離頰脂肪墊皮瓣可提供藥物相關顎骨壞死手術介入處置的新治療選擇。
並列摘要
For treatment of MRONJ, surgical intervention has became a mainstream comparing to conservative therapy which contributes to higher recovery rate. Nevertheless, how to manage the surgical defect is still a challenging issue to the surgeon. Using pedicled buccal fad pad to fill the defect is a reliable decision, but it is limited in posterior maxilla. To extend the advantage of fat pad, we are trying a newly proposed strategy that frees the fat pad and is applied in the defects outside posterior maxilla. The aim of the report is to present a 82 years old female who was diagnosised with MRONJ stage I (AAOMS 2014) over right mandible area and recieved sequestrectomy and sauceriztion. We used the free buccal fat pad graft to manage the surgical defect and ideal outcome had been observed during the follow up period. Free buccal fat pad is a new treatment option for surgical intervention of MRONJ.