以外科手術合併頰側脂肪墊修補術治療口腔粘膜下纖維化－顯微鏡觀察修補脂肪組織之變化

The Use of Surgical Excision with Prdicled Bucccal Fat Pad Graft for the Treatment of Oral Submucous fibrosis-microscopic Examination of the Pedicled Graft

陳惠庸(Hui-Yung Chen) ； 趙樵崗(Chiao-Kang Chao) ； 高文斌(Wen-Bin Gao)

《中華民國口腔顎面外科學會雜誌》 9卷1期 (1998/03) Pp. 8-13

https://doi.org/10.7104/CJOMS.199803.0008

摘要

口腔黏膜下纖維化之治療方法分爲：一、保守性治療，包含以藥物局部性注射黏膜下組織，局部性塗抹類固醇藥膏，及口服藥劑等。二、外科手術切斷纖維帶，合併作皮膚、頰側脂肪墊、包皮、或羊膜等移植術。本報告針對九名有嚴重張口受限（張口不到20mm）之口腔黏膜下纖維化患者施行外科手術切斷纖維帶合併作頰側脂肪墊修補口內缺損以改善其張口受限症狀。並在術後第0週、第1週、第2週、第3週、第4周，分別將修剪下之脂肪墊，經過formalin固定後，以H&E stain染色置於顯微鏡下觀察其組織變化以解釋變化以解釋口腔黏膜上皮細胞生長癒合之過程。結果顯示在外觀上，暴露在口腔之脂肪墊，在術後第2週與第4週之間即有上皮形成。在顯微鏡下觀察脂肪墊先由肉芽組織取代，再逐漸被複層扁平上皮由邊緣開始覆蓋，最後完全被複層扁平上皮覆蓋。

關鍵字

口腔黏膜下纖維化 ； 脂肪墊 ； 肉芽組織 ； 複層扁平上皮

並列摘要

The treatment modality of oral submucous fibrosis (OSF) includes (1). conservative treatment for mild cases, (2). surgical excision of fibrotic band combined with split-thickness skin graft, pedicled buccal fat pad (BFP) graft, prepuce graft or fresh amnion graft. Nine patients with OSF and severe mouth opening limitation (maximal interincisal distance ＜20mm) were recruited in this study. They all received surgical excision of fibrotic band combined with pedicled BFP graft. Grafts which were bulging out of the mucosal surface were trimmed off and examined microscopically at week 0,1,2,3,4 post-operatively. The conclusion was the exposed BFP graft was diminished with time clinically, the epithelization took place between week 2 and week 4 post-op. microscopically. The BFP was covered by stratified squamous epithelum from the margin and eventually covered completely.