Takagi Mikako, Kiyokawa Kensuke, Sakamoto Aritaka, Watanabe Kouichi, Rikimaru Hideaki, Inoue Yojiro, Shirouzu Toru
Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Fukuoka, Japan.
J Craniofac Surg. 2006 May;17(3):584-90. doi: 10.1097/00001665-200605000-00035.
After external decompression for a case of head trauma, epidural abscess formation resulted in extensive cranial bone and dura mater loss, for which two-stage reconstructive surgery was conducted. In the first operation, after thorough debridement of the infected wound, the dura mater was reconstructed using a bipedicle pericranial flap with posterior and anterior pedicles. After the infection had completely subsided, the second operation was performed, reconstructing the cranium with grafted outer-table calvarial bone and cutting bone to reposition an old zygomatic fracture. At this point, the pericranial flap used for dura mater reconstruction in the first operation became a satisfactory graft bed for the grafted bone. The postoperative course was satisfactory, and there was no cranial bone absorption after roughly 2 year, and a favorable shape has been maintained for an extremely satisfying result.
对于一例头部外伤患者进行外部减压后，硬膜外脓肿形成导致广泛的颅骨和硬脑膜缺损，为此进行了两阶段重建手术。在第一次手术中，对感染伤口进行彻底清创后，使用带前后蒂的双蒂颅骨膜瓣重建硬脑膜。感染完全消退后，进行了第二次手术，用移植的颅骨外板骨重建颅骨，并切开骨头重新定位陈旧性颧骨骨折。此时，第一次手术中用于重建硬脑膜的颅骨膜瓣成为移植骨的理想植骨床。术后过程顺利，大约2年后没有颅骨吸收，并且维持了良好的外形，取得了非常满意的效果。
