使用背阔肌游离皮瓣和MEDPOR植入物完成眼眶及额部重建。
Complete orbit and forehead reconstruction using a free latissimus dorsi flap and MEDPOR implants.
作者信息
Antonopoulos Dimitrios, Tsiliboti Dimitra, Skarpetas Dimitrios, Masmanidis Aris
机构信息
Plastic and Reconstructive Surgery Department, Aghios Andreas General Hospital of Patras, 74 Fanariou Street, 26226, Patras, Greece.
出版信息
Head Neck. 2006 Jun;28(6):559-63. doi: 10.1002/hed.20384.
BACKGROUND
Reconstruction of enormous composite defects of the face in the presence of meningitis is a difficult problem. We present a case of a 29-year-old man with a huge, posttraumatic bone and soft tissue defect of the upper half of the left side of the face (orbit-zygoma-frontal-partial temporal bones), frontal lobe of the brain, and enucleated eye with intact facial skin.
METHODS
An initial reconstruction using cement was complicated by multiple episodes of meningitis. In a multiple-stage procedure, we used a free latissimus dorsi muscle flap to re-construct the soft tissue defect and control the infection, a complete left orbit and frontal MEDPOR implant for the bone defect, and also an orbital sphere MEDPOR implant for the eyeball.
RESULTS
In a 2-year follow-up, no infection was observed, and the cosmetic result is satisfactory.
CONCLUSION
The combination of free flap and MEDPOR implants demonstrates an alternative method for reconstruction of complicated facial defects.
背景
在存在脑膜炎的情况下重建巨大的面部复合缺损是一个难题。我们报告一例29岁男性病例，其左侧面部上半部分（眼眶-颧骨-额骨-部分颞骨）、脑额叶以及眼球已摘除但面部皮肤完整，存在巨大的创伤后骨和软组织缺损。
方法
最初使用骨水泥进行重建，出现了多次脑膜炎发作的并发症。在多阶段手术中，我们使用背阔肌游离皮瓣重建软组织缺损并控制感染，使用完整的左眼眶和额部MEDPOR植入物修复骨缺损，还使用眼眶球MEDPOR植入物修复眼球。
结果
在2年的随访中，未观察到感染，美容效果令人满意。
结论
游离皮瓣和MEDPOR植入物的联合应用为复杂面部缺损的重建提供了一种替代方法。
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