Lee Yun-Whan, You Hi-Jin, Jung Jae-A, Kim Deok-Woo
Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea.
Arch Craniofac Surg. 2018 Jun;19(2):152-156. doi: 10.7181/acfs.2018.01830. Epub 2018 Jun 20.
Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tongue cancer excision was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall facial shape was acceptable. There was no postoperative complication during the follow-up period, 1 year and 2 months. The prefabricated implant allows the restoration of facial symmetry without harvesting autologous bone and it is a safe and effective surgical option for mandibular reconstruction.
下颌骨缺损会导致严重的畸形和功能缺陷。带血管蒂的骨皮瓣已被广泛用于下颌骨重建。然而，将这类移植物塑形使其类似下颌骨的形态在技术上具有挑战性。一名48岁女性患者在舌癌切除术后接受了股前外侧（ALT）皮瓣覆盖，随访期间被诊断为肿瘤复发。进行了广泛切除性下颌骨切除术，并采用ALT皮瓣和钛植入物进行下颌骨重建。预制钛植入物固定于髁突。然后，从同侧大腿切取ALT皮瓣并进行吻合。确认皮瓣血运完好后，将植入物固定于颏下区。术后X线片显示，假体位置良好，整体面部外形可接受。随访1年2个月期间无术后并发症。预制植入物无需取自体骨即可恢复面部对称性，是下颌骨重建的一种安全有效的手术选择。
