Iwasawa Motonao, Mishima Yoshito, Ohtsubo Miho
Department of Plastic and Reconstructive Surgery, Nagano Red Cross Hospital, Nagano, Japan.
Plast Reconstr Surg Glob Open. 2017 Aug 4;5(8):e1438. doi: 10.1097/GOX.0000000000001438. eCollection 2017 Aug.
After mandibulectomy in cancer surgery, reconstruction is often performed with a reconstruction plate covered with a soft-tissue free flap in patients in poor condition. However, the rate of complications for mandibular reconstruction is higher with a reconstruction plate than with vascularized bone grafts. We have developed a costal cartilage wrapping method to prevent exposure of the mandible reconstruction plate. The eighth costal cartilage was removed and split into 2 pieces to wrap around the reconstruction plate. In our case, the artificial plate wrapped with costal cartilage graft was not exposed and the skin over the plate did not become atrophic over 27 months follow-up even after irradiation. Wrapping around an artificial reconstruction plate with autologous costal cartilage grafts may be more effective than using only a flap covering to prevent exposure of the plate after tumor ablation and radiation therapy.
在癌症手术中进行下颌骨切除术后，对于身体状况较差的患者，通常采用覆盖游离软组织瓣的重建钢板进行重建。然而，使用重建钢板进行下颌骨重建的并发症发生率高于使用血管化骨移植。我们开发了一种肋软骨包裹方法以防止下颌骨重建钢板暴露。切除第八肋软骨并将其分成两片以包裹重建钢板。在我们的病例中，包裹肋软骨移植的人工钢板未暴露，并且在长达27个月的随访中，即使经过放疗，钢板上方的皮肤也未出现萎缩。用自体肋软骨移植包裹人工重建钢板可能比仅使用皮瓣覆盖更有效地防止肿瘤切除和放疗后钢板暴露。
