Turan Aydin, Kostakoğlu Naci, Tuncel Umut, Gökçe Erkan, Markoç Fatma
From the Departments of *Plastic, Reconstructive and Aesthetic Surgery, †Radiology, and ‡Pathology, Gaziosmanpaşa University Medical School, Tokat, Turkey.
Ann Plast Surg. 2016 May;76(5):509-16. doi: 10.1097/SAP.0000000000000357.
There is still no consensus on the ideal material to be used in craniofacial defects. Autogenous bone grafts are mostly preferred owing to their use with fewer complications. The aim of this study was to evaluate whether the scapular bone graft can be used with equal or more advantages to other bone graft resources in orbital, maxillary sinus front wall, and frontal bone defects.
Twenty-four orbital, maxillary sinus front wall, and frontal bone defects were reconstructed with scapular bone grafts. Sixteen patients presented with complicated orbital fractures, 5 patients presented with isolated orbital floor fractures, and 3 patients presented with frontal bone fractures. The grafts were radiologically evaluated 1 day, 6 months, and 12 months postoperatively by 3-dimensional computed tomography scan.
All orbital, maxillary sinus front wall, and frontal bone defects were reconstructed successfully with scapular bone grafts. Clinical evaluation of the patients at 6 to 24 months of follow-up was considered satisfactory. Minimal donor site morbidity was observed. Scapular bone grafts adapted nicely to the recipient area, and bony union was complete as demonstrated by 3-dimensional computed tomography scans.
Reconstruction of orbital, maxillary sinus front wall, and frontal bone defects with scapular bone grafts is an easy and safe procedure with minimal donor site morbidity. Scapular bone graft is a good reconstructive option for orbital, maxillary sinus front wall, and frontal bone defects.
对于颅面缺损所使用的理想材料仍未达成共识。自体骨移植因其并发症较少而最为常用。本研究的目的是评估肩胛骨移植在眼眶、上颌窦前壁和额骨缺损修复中是否能比其他骨移植来源具有同等或更多优势。
采用肩胛骨移植修复24例眼眶、上颌窦前壁和额骨缺损。16例患者为复杂眼眶骨折，5例患者为单纯眶底骨折，3例患者为额骨骨折。术后1天、6个月和12个月通过三维计算机断层扫描对移植骨进行影像学评估。
所有眼眶、上颌窦前壁和额骨缺损均成功采用肩胛骨移植修复。随访6至24个月时对患者的临床评估结果令人满意。供区并发症轻微。肩胛骨移植与受区适配良好，三维计算机断层扫描显示骨愈合完全。
采用肩胛骨移植修复眼眶、上颌窦前壁和额骨缺损是一种简单、安全的手术，供区并发症轻微。肩胛骨移植是修复眼眶、上颌窦前壁和额骨缺损的良好选择。
