Wang Weijian, Duan Jianmin, Wang Qiao, Kuang Wei
Department of Oral and Maxillofacial Surgery, General Hospital of Guangzhou Military Command of PLA Guangzhou 510010, China.
Department of Oral Implantology, General Hospital Guangzhou Military Command of PLA Guangzhou 510010, China.
Int J Clin Exp Med. 2015 Jan 15;8(1):1427-33. eCollection 2015.
In this report, we described clinical outcomes of a multi-stage surgery integrating multiple techniques in restoration of facial morphology and function of a 17-year-old boy with severe gunshot injuries. This multi-stage surgery was applied in treatment of one rare case of gunshot-caused complicated facial deformities involving most parts of the face (labrum, left nose wing, nasal columella, nasal septum, maxillary alveolar process, hard palate, soft palate, bilateral maxillary bones, left zygoma, suborbital bone defects) and clinical efficacy upon restoring facial form and function were retrospectively evaluated. The patient was diagnosed with massive facial defects and deformities caused by gunshot, which led to feeding difficulty, severe articulation disorders and serious facial disfigurement. To reconstruct facial form and restore functions of mastication and articulation, multiple examinations and surgical procedures including mirror imaging, rapid prototyping technique, porous titanium implants, microscopic surgical technique, dental implants, osteomyocutaneous flap, muscular flap, shifting and repairing of adjacent tissue flaps and free bone graft reconstruction were undertaken. Postoperatively, reconstruction of severe facial disfigurement and restoring basic functions including articulation and feeding for the first time and relatively sound clinical outcomes have been obtained, which may add clinical evidence to the treatment of similar cases of severe facial deformities.
在本报告中，我们描述了一名17岁严重枪伤男孩的多阶段手术临床结果，该手术整合了多种技术以恢复面部形态和功能。此多阶段手术应用于治疗一例罕见的枪伤所致复杂面部畸形病例，该畸形累及面部大部分区域（唇、左鼻翼、鼻小柱、鼻中隔、上颌牙槽突、硬腭、软腭、双侧上颌骨、左颧骨、眶下骨缺损），并对恢复面部形态和功能的临床疗效进行了回顾性评估。患者被诊断为枪伤导致的大面积面部缺损和畸形，这导致进食困难、严重的发音障碍和严重的面部毁容。为重建面部形态并恢复咀嚼和发音功能，进行了多项检查和手术操作，包括镜像成像、快速成型技术、多孔钛植入物、显微外科技术、牙种植体、骨肌皮瓣、肌瓣、相邻组织瓣的移位和修复以及游离骨移植重建。术后，严重面部毁容得到重建，首次恢复了包括发音和进食在内的基本功能，并取得了相对良好的临床效果，这可能为治疗类似严重面部畸形病例增添临床依据。
