Clinical Study Of Mandibular Bone Flap Pedicled With Temporal Muscle To Repair Maxillary Defects

Objective:The maxillary tumor is the common diseases in the oral and maxillofacial surgery, and the maxillary defect often can cause facial deformity. If not repaired in time, it will give patients bring serious mental and physical barriers. This report will study on function in mandibular bone flap pedicled with temporal muscle repairing maxillary defects through Measuring the preoperative and the postoperative recovery the temporal muscle and masseter muscle electromyography and Determining the health side chew function and comparing them.Methods:We collected the data of20maxillary tumor patients accepted Surgical treatment in our department from may of2011to January of2012. Among the20patients there were13males and7females, aged39to72and average age was59.6. The shortest medical history was3months, the longest was1and a half years. This group of patients are routinely performed according to prepare for the operation, Examining the masseter muscle and temporal muscle electromyography before operation, and Determining the health side chew function by the way of Chewing peanut. Reviewing the masseter muscle and temporal muscle electromyography after one month, and also determining the health side chew function by the way of Chewing peanut(Because of The shortest medical history of this group was3months, Patients do not use the trouble side to chew, The function of the trouble side has loss, so we can only measure the health side chew efficiency). According to the following formula to calculate chew efficiency:chew efficiency=(Total amount-surplus)/Total amount×100%. All operations are done by the same doctors. Each patient asked a questionnaire survey after one month, that did their subjective feeling of Chewing food are affected. When reviewing we observed patients facial appearance^The size of opening mouth、the shape of Open the mouth and the bite relationship of residual teeth in oral cavity. The datas of Chew efficiency were indicated as mean±standard deviation(x±s). Statistics processing applications SPSS16.0statistical software for analysis.We comprehensive analysis and research the change of function through measuring the preoperative and the postoperative recovery the temporal muscle and masseter muscle electromyography and Determining the health side chew efficiency and comparing them, patients subjective feeling of Chewing food and observing patients facial appearances the size of opening mouth、the shape of opening the mouth and the bite relationship of residual teeth in oral cavity, to evaluate mandibular bone flap pedicled with temporal muscle repairing maxillary defects in the clinical application effect.Results:This group of20patients had the forearm flap and mandibular bone flap are survived well, and all patients have the facial appearance basic symmetry after half a month, the size of mouth opening can reach1.5-2cm, and the shape of open mouth is "↓".17cases of them have a normal occlusal relationship,3cases of them have slightly wrong occlusal relationship, mainly of which is the mandibular shift to the health side. Reviewing after one month, all patients have the facial appearance basic symmetry, the size of mouth opening can reach2.7-3.5cm, and the shape of open mouth is "↓", and all of them of them have a normal occlusal relationship. To review of the masseter muscle and temporal muscle electromyography, we find that the masseter muscle and temporal muscle movement unit time change have no significant differences, and also have no significant differences between preoperative chewing efficiency and that after one month (P>0.05). With11patients complained of continuous eating a long time (more than1minutes),they feel that the health side masseter muscle and temporal muscle have discomfort feeling, another9patients because their medical history is long, they have long-term health of unilateral chewing, having no obvious difference between Preoperative and postoperative.Conclusion:Mandibular bone flap pedicled with temporal muscle nearby upper jaw, using it to repair upper jaw bone defect accord with repair reconstruction surgery principle. All patients have the facial appearance basic symmetry after Using mandibular bone flap pedicled with temporal muscle to repair the maxillary’s defects. Although it will appear open mouth mild limited after half a month, A small percentage of them (3/20) have slightly wrong occlusal relationship, but the situation will get improvement after a month. The contrast between electromyography and chewing efficiency preoperative and electromyography and chewing efficiency postoperative stated that mandibular bone flap pedicled with temporal muscle repairing the maxillary’s defects have little effect on chewing function. With11patients complained of continuous eating a long time (more than1minutes), they feel that the health side masseter muscle and temporal muscle have discomfort feeling, Showing the health side masseter muscle and temporal muscle have limited role in compensatory function. It is expected to solve this problem through the denture repair.