[定制植入物用于复杂面部重建：一例颞下颌关节、颧弓和颧骨全置换病例]
[Custom-made implant for complex facial reconstruction: A case of total replacement of temporo-mandibular joint, zygomatic arch and malar bone].
作者信息
Guillier D, Moris V, See L-A, Girodon M, Wajszczak B-L, Zwetyenga N
机构信息
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France; Lipids nutrition cancer team NuTox UMR866, university Bourgogne Franche-Comté, boulevard Jeanne-d'Arc, 21000 Dijon, France.
出版信息
J Stomatol Oral Maxillofac Surg. 2017 Feb;118(1):52-56. doi: 10.1016/j.jormas.2016.12.005. Epub 2017 Feb 3.
INTRODUCTION
Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures.
CASE
A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene). Five years postoperatively, mouth opening, nutrition, pain and oral hygiene were significantly improved.
DISCUSSION
Nowadays technical possibilities allow for complex facial alloplastic reconstructions with good medium term results.
引言
颞下颌关节（TMJ）全关节置换已成为一种常见手术，但通常局限于颞下颌关节本身。我们报告一例复杂的人工关节重建病例，该重建延伸至邻近骨结构。
病例
一名57岁患者因颅面骨纤维发育不良接受过多次手术，现出现复发性颞下颌关节强直及右侧复杂的面侧骨质缺损。我们采用定制的复合假体（铬钴钼钛合金和聚乙烯）对颞下颌关节、颧弓和颧骨进行了重建手术。术后五年，患者的张口度、营养状况、疼痛及口腔卫生均有显著改善。
讨论
如今的技术手段使得复杂的面部异体植入重建成为可能，并能取得良好的中期效果。
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