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采用下颌骨剩余部分矢状劈开截骨术重建骨性颏部 - 一种特殊适应证的新技术:病例报告。

Reconstruction of the bony chin using sagittal split osteotomies of the remaining mandible - A new technique for a special indication: Case report.

机构信息

Department of Oral- and Maxillofacial Surgery (Head: Prof. Dr. Dr. B. Hell), Diakonie Klinikum Jung-Stilling, Wichernstraße 40. 57074, Siegen, Germany.

出版信息

J Craniomaxillofac Surg. 2017 Sep;45(9):1378-1386. doi: 10.1016/j.jcms.2017.06.002. Epub 2017 Jun 16.

Abstract

There are several indications for resecting the bony chin, such as squamous cell carcinoma, sarcoma, or benign tumors of the jaw such as ameloblastoma. Several techniques for reconstruction of the bony chin, such as the use of metal plates and also revascularized free bone grafts of the iliac crest, fibula, or scapula, are common. In the case of poor vascular supply, however, alternative techniques may be necessary. In this report, a new technique is described using pedicled bone flaps from both sagittally split mandibular stumps following chin resection. These flaps were pedicled on the mylohyoid muscles and advanced to restore the continuity of the mandible. An advantage of this procedure was minimization of the soft tissue defect, making repair easier. Morbidity of the resection and reconstruction was thus reduced, and recovery of the patient was very quick.

摘要

有几种情况下需要切除骨性下巴,例如鳞状细胞癌、肉瘤或颌骨良性肿瘤,如造釉细胞瘤。重建骨性下巴有几种常见的技术,例如使用金属板和带血管游离骨移植,如髂嵴、腓骨或肩胛骨。然而,在血供不佳的情况下,可能需要其他技术。在本报告中,描述了一种新的技术,即使用颏下切除后双侧矢状劈开下颌骨残端的带蒂骨瓣。这些皮瓣蒂位于下颌舌骨肌上,向前推进以恢复下颌骨的连续性。该手术的优点是最大限度地减少软组织缺损,使修复更容易。因此,降低了切除和重建的发病率,患者的恢复非常迅速。

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