CẬP NHẬT TẠO HÌNH KHUYẾT HỔNG LỚN VÙNG HÀM MẶT

Abstract

Objective: to update the methods of reconstructing large defects in the maxillofacial region, to evaluate the results of these methods. Methods: Retrospective, cross-sectional description of 106 patients treated for immediate reconstruction of large defects after maxillofacial tumor resection surgery from January 2020 to December 2023. Results: The most common defect in the study was the mandibular defect, accounting for 50.94% of the total number of cases; the tongue-floor defect accounted for 24.52% and the partial maxillary defect accounted for 19.81%; in addition, there were large defects penetrating the cheek area, accounting for 4.72%. 100% of patients had no restriction in opening their mouth after surgery. The most commonly used method was the free fibula flap in 65 patients with maxillary or mandibular reconstruction, accounting for 61.32%; followed by the free lateral arm flap in 26 patients with tongue-floor reconstruction, accounting for 24.52%; Local flaps combined with immediate maxillary bone restoration were applied to 11 patients, accounting for 10.38%, and 6 anterior lateral thigh flaps were used to reconstruct cheek defects and create large coverage of the mandible, accounting for 6.66%.. Long-term functional results after 6 months, no patient had to eat through a tube and eat liquid food, 8 patients (7.54%) ate solid food and 98 patients (92.45%) could eat and drink normally. Long-term follow-up results on facial aesthetics, no patient had poor aesthetic results; 8.49% of patients had fair aesthetic results and 91.51% of patients had good aesthetic results. Conclusion: Choosing the most suitable flaps for the defect is important in rehabilitation. The application of 3D digital imaging technology combined with flexible use of imaging methods can bring patients good results in terms of function as well as facial aesthetics after surgery to remove large tumors in the maxillofacial region.