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首页> 外文期刊>Journal of reconstructive microsurgery >Challenging the Orthodoxy of Mandibular Reconstructions Comparing Functional Outcomes in Osseous versus Soft Tissue Reconstructions of the Posterolateral Mandible
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Challenging the Orthodoxy of Mandibular Reconstructions Comparing Functional Outcomes in Osseous versus Soft Tissue Reconstructions of the Posterolateral Mandible

机译：挑战颌骨重建的正统比较骨对与软组织重建的功能结果进行了比较

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Background Appropriate reconstruction of the posterolateral mandible remains controversial. Both osseous and soft tissues are vital components for an overall successful outcome and are often combined in complex defects. Their respective effect on oromandibular function in the reconstruction of different degrees of mandibular defects has been less evaluated. This study aimed to compare patient-perceived oromandibular function in osseous and soft tissue-only reconstructions following posterolateral mandibular defects, defined as limited or extended. Patients and Methods A 10-year retrospective review of consecutive patients undergoing mandibular reconstructions of the posterolateral mandible were identified. Limited defects were defined as reaching from the ipsilateral parasymphysis to anterior of the coronoid (sparing insertion of muscles of mastication). Extended defects were defined as reaching from the ipsilateral parasymphysis to posterior of the coronoid (sacrificing the muscle insertions). Functional outcomes were assessed using the University of Washington Quality of Life questionnaire, version 4. Results A total of 163 patients were identified, of which 41 patients had the particular posterolateral mandibular resections sought after. In 23 limited resections, there was no difference in functional outcome between osseous and soft tissue-only reconstructions. In 18 patients undergoing extended resections, osseous reconstructions demonstrated significantly better outcomes ( p = 0.011). There were no significant differences in patient demographics between the groups. Conclusion Our study highlights the interest of soft tissue-only reconstructions of the posterolateral mandible. Limited resections seem not to benefit from complex osseous reconstruction for adequate function. Conversely, there is a noteworthy positive impact on functional outcomes in extended posterolateral mandibulectomies reconstructed with osseous tissue, compared with soft tissue only. Although a larger study is needed to identify a stronger relationship, these preliminary results could aid reconstructive decisions, particularly when considering patient morbidity.
机译：背景技术后外侧下颌的适当重建仍然存在争议。骨质和软组织既是整体成功结果的重要组成部分，经常在复杂的缺陷中组合。它们对不同程度的下颌缺陷的重建中的oromandibular功能的各自作用已经不太评价。本研究旨在比较在后侧下颌缺陷后的骨质和软组织的重建中的患者感知的oromandibular功能，定义为有限或延伸。患者和方法鉴定了对经历颌骨外部颌骨下颌重建的连续患者的10年来回顾性审查。限制缺陷被定义为从同侧血小面瘤术中到达冠状胰岛素（保留肌肉肌肉的肌肉腐烂）。将延长的缺陷定义为从同侧诉讼到冠状胰岛素的后退（牺牲肌肉插入）。使用华盛顿大学生活质量调查问卷的评估功能结果，4.结果鉴定了163名患者，其中41名患者追捧了特定的后侧颌骨切除。在23例有限的切除中，骨质和软组织重建之间的功能结果没有差异。在18名患者中进行延长切除术，骨质重建明显更好的结果（P = 0.011）。群体之间的患者人口统计学没有显着差异。结论我们的研究突出了后侧下颌软组织重建的兴趣。有限的切除似乎没有受益于复杂的骨质重建以获得足够的功能。相反，与软组织相比，与骨组织重建的延长的后侧悬膜中的功能结果存在值得注意的积极影响。虽然需要更大的研究来识别更强的关系，但这些初步结果可以帮助重建决策，特别是在考虑患者的发病率时。

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