摘要
在牙科臨床上不論何種原因造成之口鼻瘻管，手術目的即要改善患者說話、飲食吞嚥、呼吸、假牙之穩定性及外觀等功能。至於修補方法則視瘻管實際大小及位置而定，臨床上發現硬組織缺損大於軟組織，故除一般學理檢查外更需靠探針及X-光合併診斷才能確知範圍，絕不可以肉眼所見為準。較大的口鼻瘻管多採用雙層覆蓋術及使用手術移植架來增加手術成功機會。至於選擇何種雙層覆蓋術則需經過取模、探測缺損範圍及紙模作業才能決定。本文提出一病例為69歲男性製作上顎全口義齒時，因口鼻瘻管將樹脂壓入鼻腔，經耳鼻喉科醫師由鼻内夾出後轉入本科治療口鼻瘻管，經Fickling-Inkwell及上腭島瓣合併手術，另用K-wire固定手術移植架，術後島瓣生長良好。一般於文獻的記載上，對口竇瘻管多所陳述，而對於口鼻瘻管之陳述較少，本文除提出病例外，並強調在術前一定要有妥善的治療計劃，力求島瓣容易旋轉，且張力減至最小，並有豐富血管供應；另提及手術移植架在全口無牙患者簡易固定之方法。
並列摘要
The surgical management of oronasal fistula is to improve the functions such as: speech, swallowing, respiration, denture stability and cosmetics. The method of surgical repair will depend on the actual size of fistula. It is not sufficient to determine the size of fistula only by inspection, other examination such as probing and radiograph should be performed. The surgical management with double-layer flap method and stent application would increase success rate. In clnic, there are 4surgical measure of the choices of double-layer flap 1.precise impression 2.marginprobing and detection 3.paper surgery and 4.model study. The proper physical examination and complete treatment plan before the operation to ensure the easy rotation of the flap as well as least tension for enough blood supply are essential prior any surgical intervention at present report was strongly recommeded. A case of 69-year-old male patient with upper full denture, been suffered from oronasal fistula when local dentist relining resing on corresponding area of full denture; The resin was forced into nasal cavity. He was transfered to local E.N.T. clinic to romove necrotic bone and resin. Since fistula still persisted so he was referred to our department. The Fickling-Inkwell and palatal island flap surgical measure was carried out by our department. K-wire to fix the stent was applied. In this case, prognosis of the patient after surgery was very progressively. We noted that the operation not only reduced the patient's discomfort but also facilitated the healing of operation wound. It seems much better than any traditional surgery.
並列關鍵字
無資料延伸閱讀
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