双侧大和鼻腔硬结构的同时重建,使用血管化和非血管化骨
Itaru Tsuge1, Hiroki Yamanaka1, Motoki Katsube1
1From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Plastic and reconstructive surgery. Global open
|June 26, 2024
概括
这项研究提出了一种新的双自由技术,用于癌症手术和放射治疗后复杂的中脸部重建. 该方法成功地恢复了口腔功能和面部结构,为具有挑战性的病例提供了可行的解决方案.
科学领域:
- 整形外科 整形外科 整形外科
- 头部和部重建的重建
- 瘤外科手术 瘤外科手术
背景情况:
- 涉及鼻腔结构和部的广泛的中脸部缺陷给重建带来了重大挑战.
- 术后放射治疗引起的皮肤收缩复杂化了二次重建工作.
- 一名57岁的患者出现了严重的中脸部抑郁和由于癌症后切除和放射治疗诱导的骨质放射性缩而导致的功能缺陷.
研究的目的:
- 描述双边大和鼻腔硬结构的同时重建技术.
- 为了评估双自由 (支柱骨皮和前侧大腿) 方法的有效性.
- 为解决因中脸部缺陷引起的口服和对话功能障碍.
主要方法:
- 采用了一种嵌合式的双自由策略,涉及到一个骨皮膜和一个前侧腿.
- 长片为结构重建提供了血管化骨,而非血管化部分用于鼻桥和.
- 前侧大腿被定制为口腔闭合,鼻腔内,并覆盖重建的鼻子结构.
主要成果:
- 实现了双边大和硬鼻结构的同时成功重建.
- 嵌合体板恢复了口服摄入量,对话能力和面部中部突出.
- 8个月后的手术后CT扫描显示,骨结构保持不变,没有感染或暴露.
结论:
- 描述的双自由技术为复杂的面部中部缺陷提供了强大的解决方案,特别是在放射治疗后.
- 使用非血管化的长片有效地防止了重建框架的感染和暴露.
- 这种方法在一个具有挑战性的瘤重建病例中显著改善了功能结果,包括口服摄入和语音.
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Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...