Suga Hirotaka, Asato Hirotaka, Okazaki Mutsumi, Okochi Masayuki, Narushima Mitsunaga
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
J Craniofac Surg. 2007 May;18(3):639-42. doi: 10.1097/scs.0b013e3180333f22.
In secondary reconstruction of the maxilla, skeletal reconstruction as well as soft tissue augmentation is required to obtain a good contour. We present a new strategy for combining a costal cartilage graft with a rib-latissimus dorsi flap. We used this method to treat a 39-year-old man who had previously undergone total maxillectomy. First, a vascularized rib, elevated together with a latissimus dorsi flap, was fixed between the middle of the maxilla and the edge of the zygomatic arch. The small defects that could not be reconstructed with the rib only were reconstructed with a costal cartilage graft. The patient did not develop any postoperative infection or flap necrosis. Thirteen months after the secondary reconstruction, he presented with a good contour of the cheek. Our method was effective for the reconstruction of a complex skeletal defect of the maxilla.
在上颌骨二期重建中，需要进行骨骼重建以及软组织增量以获得良好的外形。我们提出一种将肋软骨移植与肋骨-背阔肌皮瓣相结合的新策略。我们使用这种方法治疗了一名此前接受过全上颌骨切除术的39岁男性。首先，将带血管的肋骨与背阔肌皮瓣一起掀起，固定于上颌骨中部和颧弓边缘之间。仅用肋骨无法重建的小缺损则用肋软骨移植进行重建。患者术后未发生任何感染或皮瓣坏死。二期重建13个月后，他的面颊外形良好。我们的方法对于上颌骨复杂骨骼缺损的重建是有效的。
