Eweida Ahmad M, Horch Raymund E, Marei Mona K, Elhammady Habashi A, Etaby Ashraf N, Nabawi Ayman S, Sakr Mahmoud F
Head and Neck and Endocrine Surgery, Faculty of Medicine, University of Alexandria, Egypt; Tissue Engineering Laboratories, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt.
Plastic, Reconstructive and Hand Surgery Department, Hospital Erlangen, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
J Craniomaxillofac Surg. 2015 Sep;43(7):1028-32. doi: 10.1016/j.jcms.2014.10.018. Epub 2014 Oct 29.
Applying regenerative therapies in the field of cranio-maxillofacial reconstruction has now become a daily practice. However, regeneration of challenging or irradiated bone defects following head and neck cancer is still far beyond clinical application. As the key factor for sound regeneration is the development of an adequate vascular supply for the construct, the current modalities using extrinsic vascularization are incapable of regenerating such complex defects. Our group has recently introduced the intrinsic axial vascularization technique to regenerate mandibular defects using the arteriovenous loop (AVL). The technique has shown promising results in terms of efficient vascularization and bone regeneration at the preclinical level. In this article, we have conducted a narrative literature review about using the AVL to vascularize tissue-engineering constructs at the preclinical level. We have also conducted a systematic literature review about applying the technique of axial vascularization in the field of craniofacial regeneration. The versatility of the technique and the possible challenges are discussed, and a suggested protocol for the first clinical trial applying the AVL technique for mandibular reconstruction is also presented.
在颅颌面重建领域应用再生疗法如今已成为日常实践。然而，头颈部癌症后具有挑战性的或受辐射的骨缺损的再生仍远未达到临床应用阶段。由于良好再生的关键因素是为构建物建立充足的血管供应，目前使用外在血管化的方式无法再生此类复杂缺损。我们团队最近引入了内在轴向血管化技术，利用动静脉袢（AVL）来再生下颌骨缺损。该技术在临床前水平的有效血管化和骨再生方面已显示出有前景的结果。在本文中，我们对在临床前水平使用AVL为组织工程构建物进行血管化进行了叙述性文献综述。我们还对在颅面再生领域应用轴向血管化技术进行了系统的文献综述。讨论了该技术的多功能性和可能面临的挑战，并提出了首个将AVL技术应用于下颌骨重建的临床试验的建议方案。
