颌面部肿瘤患者的骨科治疗

I. V. Pustovaya, M. Engibaryan, P. Svetitskiy, I. V. Aedinova, V. L. Volkova, N. A. Chertova, Yulia Ulianova, M. V. Bauzhadze
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引用次数: 2

摘要

的相关性。分期矫形治疗用于改善接受根治性颌面癌手术患者的生活质量。患者和方法。1998年至2018年,在俄罗斯卫生部国家肿瘤医学研究中心头颈部肿瘤科对197名接受颌面部癌症治疗的患者进行了观察。所有患者都接受了根治性手术治疗,导致术后上颌、颧颊眶区软组织、鼻或耳廓缺损。159例(80.7%)患者使用了可拆卸的闭孔假体和各种支撑和固定元件。38例(19.3%)患者单独行面部假体:外眶假体17例(44.7%),外鼻假体14例(36.8%),外颧-颊-眶假体6例(15.8%),外耳廓假体1例(2.7%)。采用可拆卸上颌闭孔和鼻假体联合修复4例[1];可拆卸上颌闭孔及眼假体。联合假体通过磁铁相互固定。根据患者的审美要求和生活质量对修复效果进行评价。颌面部假体可以完全恢复咀嚼、吞咽和说话功能,恢复面部变形,改善患者的外观。恶性肿瘤根治术后颌面部缺损患者的及时、全面的骨科治疗在综合康复措施中占主要地位。早期消除大面积缺损的目的是最大限度地恢复口腔功能障碍和保持外观。颌面假体的明显优势包括改善患者的社会适应和生活质量,促进完全康复和重返社会有用的活动。
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Orthopedic treatment in cancer patients with maxillofacial pathology
Relevance. Staged orthopedic treatment was used to improve the quality of life of patients who underwent radical maxillofacial surgeries for cancer.Patients and methods. 197 patients receiving treatment for maxillofacial cancer were observed at the Department of head and neck tumors, National Medical Research Centre for Oncology of the Ministry of Health of Russia, in 1998- 2018. All patients underwent radical surgical treatment resulting in postoperative defects of the upper jaw, soft tissues of the zygomatic- buccal-orbital region, nose, or auricle.Results. Removable obturator prostheses with various supporting and retaining elements were made for 159 (80.7 %) patients. Individual facial prostheses were made for 38 (19.3 %) patients: 17 (44.7 %) – external orbital prostheses, 14 (36.8 %) – external nasal prostheses, 6 (15.8 %) – external zygomatic- buccal-orbital prostheses, 1 (2.7 %) – external auricle prosthesis. Combined prostheses were made for 4 patients– removable upper jaw obturator and nose prosthe[1]sis; removable upper jaw obturator and eye prosthesis. Combined prostheses were fixed to each other using magnets. The results of maxillofacial prosthetics were evaluated according to the aesthetic requirements of the patients and their quality of life. Maxillofacial prostheses allowed a complete restoration of chewing, swallowing, and speaking, restored facial deformation, and improved the appearance of patients.Conclusions. Timely and comprehensive orthopedic treatment of patients with postoperative maxillofacial defects after radical surgeries for malignant tumors takes the main place in the complex of rehabilitation measures. Early elimination of extensive defects is aimed at maximum restoration of oral dysfunctions and appearance preservation. The apparent advantages of maxillofacial prostheses involve improvement of social adaptation and the quality of life of patients, which promotes complete rehabilitation and a return to socially useful activities.
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