Eski Muhitdin, Nisanci Mustafa, Cil Yakup, Sengezer Mustafa, Ozcan Ayhan
Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Etlik, Ankara, Turkey.
J Craniofac Surg. 2005 Jul;16(4):675-83. doi: 10.1097/01.scs.0000168778.01851.29.
Distraction osteogenesis has recently become popular in craniofacial reconstruction, after it was first described for long bones. Despite the widespread clinical use of this technique, currently, lack of an ideal experimental model for small animals hampers investigations focused on its molecular basis, which warrants further elucidation. The authors developed a new device for distraction of the rat mandible and, to asses its effectiveness, practiced on 30 animals assigned to either an acute 3-mm distraction group (n = 7) or a gradual distraction group (0.25 mm twice a day for 6 days; n = 23). The authors applied the devices to a localization that allowed them to perform the ostomies posterior to the molar teeth. Because of a U-shaped plate that the authors used for posterior pin fixation, their device maintained its stability until the end of the study, despite the delicate anatomy of the bone at the posterior part of the mandible. Additionally, the authors described a practical and easy method of transient mandibular stabilization method that facilitates the manipulations while the mouth is open for safer airway control during surgery. This new nutrition technique with enteral feeding solution solved the problem of progressive weight loss after surgery. Application of the device was easy and practical, without demanding complex manipulations. The authors did not observe any device dislodgement or a high rate of accidental fractures during the manipulations. They demonstrated that the device works properly and is able to create ossified regenerate bones that fill the entire distraction gap, which can be used for various investigations during distraction osteogenesis.
牵张成骨技术最初用于长骨,近来在颅面重建中受到广泛关注。尽管该技术在临床上已广泛应用,但目前缺乏理想的小动物实验模型,这阻碍了对其分子机制的研究,因此有必要进一步阐明。作者开发了一种用于牵张大鼠下颌骨的新装置,并通过将30只动物分为急性3毫米牵张组(n = 7)或逐渐牵张组(每天两次,每次0.25毫米,持续6天;n = 23)来评估其有效性。作者将装置放置在磨牙后方进行截骨术的位置。由于作者使用U形板进行后方针固定,尽管下颌骨后部的骨骼解剖结构精细,但该装置在研究结束前一直保持稳定。此外,作者描述了一种实用且简便的临时下颌骨稳定方法,该方法在手术中张口时便于操作,有助于更安全地控制气道。这种新的肠内营养技术解决了术后体重逐渐减轻的问题。该装置的应用简便实用,无需复杂操作。作者在操作过程中未观察到任何装置移位或意外骨折的高发生率。他们证明该装置运行良好,能够形成填充整个牵张间隙的骨化再生骨,可用于牵张成骨过程中的各种研究。