目的：分析上颌骨缺损的类型及修复方法，探讨二者之间的关系。方法：统计北京大学口腔医学院1985年1月至2010年12月收治的1 107例上颌骨缺损病例的Brown分类及其修复方法。结果：1 107例中可按Brown分类的1 104例缺损中，最常见的为2a类缺损（559例，50.6%）。1 107例患者中，自体组织移植修复349例，修复体修复443例，未修复107例,失访208例。应用游离皮瓣修复上颌骨缺损的比例呈增长趋势，修复体的应用呈下降趋势。上颌骨缺损重建最常用的游离皮瓣为腓骨瓣和前臂皮瓣，股前外侧皮瓣和腹直肌皮瓣较多应用于大型缺损。结论：上颌骨缺损的类型中，最多见的为Brown 2a类缺损；游离组织瓣已成为上颌骨缺损重建的最常用方法，可根据上颌骨缺损类型选择相应的游离组织瓣。
Objective： To investigate the defect types and reconstruction methods of maxillary defects.Methods: The database of 1 107 cases with maxillary defects in Peking University School and Hospital of Stomatology from January 1985 to December 2010 was established. There construction methods were reviewed. The defect types were classified according to Brown classification system.Results: In the 1 107 cases, 1 104 cases could be classified according to Brown classification system. The most common type was 2a with 559 cases (50.6%). Among all the 1 107 cases, 349 cases were reconstructed with autotransplantation, 443 cases with prosthesis, 107 cases untreated, and 208 patients lost to the followup. There was a significant growing trend over time for the application of free flaps and a downward trend of prosthesis. The most popular free flaps were fibular flap (88 cases) and radial forearm flap (75 cases). Rectus abdominis flap and anterolatreal thigh flap were fit for extensive maxillary defects.Conclusion:The most common defect type is 2a. Free flap has become the dominant option for maxillary reconstruction. Free flaps could be selected according to the maxillary defect types.
