关键词: 上颌骨, 缺损, 3D打印, 修复重建

Abstract: Objective To evaluate the clinical efficacy of restorations of maxillary defects by microvascular free flaps and individual titanium meshes based on 3D printed maxilla models. Methods Retrospective analysis of 18 cases with maxillary defects from 2011 to 2013 was made. For all the cases, 3D models internally fixed with titanium meshes fabricated according to preoperative CT data were implanted to support their faces, and microvascular free flaps were used to close their oral and nasal cavities. Results 4 cases used rectus abdominis muscle flaps, 6 cases forearm flaps, 3cases lateral arm flaps, and 5 cases anterolateral thigh flaps. All flaps were alive. Moreover, faces of all cases were symmetric, closure of oral and nasal cavities as well as maxillary sinus was complete so that all cases were able to eat through oral cavities, and their postoperative vocalization was clear. Only 2 cases with soft palate defects occasionally suffered from mild nasal regurgitation when having liquid diets. Conclusion Individualized 3D models and titanium meshes combined with microvascular free flaps used in restoring maxillary defects can obtain satisfactory functional and aesthetic outcomes for patients. However, the effects of closing oral and nasal cavities by free tissue flaps on the restoration of false teeth needs to be further explored.

Key words: maxillary , defect, 3d printing technology, 　reconstruction