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内镜辅助下额窦前壁骨折复位术

Endoscopic-assisted reduction of anterior table frontal sinus fractures.

作者信息

Steiger Jacob D, Chiu Alexander G, Francis David O, Palmer James N

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

Laryngoscope. 2006 Nov;116(11):1978-81. doi: 10.1097/01.mlg.0000236508.50443.0d.

Abstract

In this study, we examined salvage operations after reexploration in head and neck reconstruction and analyzed ways to solve problems. Free flap reconstruction of the head and neck lesion was carried out for 513 cases in our hospital over the past 12 years. Twenty-one cases of reexploration were caused by postoperative thrombosis (4.1%). We could only salvage seven cases (33.3%) of 21 cases from flap thrombosis. All seven cases were included in the category of venous thrombosis, and they were undertaken within 3 days postoperatively. Our results have shown that once thrombosis occurs, there is little possibility of flap salvage, particularly 3 days after operation and in infectious cases. When no flow phenomena are observed and no flap salvage is deemed possible, aggressive treatment such as a second free flap or next pedicle flap should be chosen as soon as possible to avoid any delay in postoperative treatment.

摘要

在本研究中,我们检查了头颈重建再次探查后的挽救手术,并分析了解决问题的方法。在过去12年里,我院对头颈病变进行了513例游离皮瓣重建。21例再次探查是由术后血栓形成引起的(4.1%)。在21例皮瓣血栓形成病例中,我们仅挽救了7例(33.3%)。所有7例均属于静脉血栓形成,且均在术后3天内进行处理。我们的结果表明,一旦发生血栓形成,皮瓣挽救的可能性很小,尤其是术后3天以及感染病例。当未观察到血流现象且认为无法挽救皮瓣时,应尽快选择积极的治疗方法,如再次游离皮瓣或下一个带蒂皮瓣,以避免术后治疗的任何延误。

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