Oberna Ferenc, Czuczor Marcell, Füzes Attila
Arc-, Állcsont Szájsebészeti és Fül-orr Gégészeti Osztály, Bács-Kiskun Megyei Kórház, Kecskemét, Hungary.
Anatómia, Szövet- és Fejlõdéstani Intézet, Semmelweis Egyetem, Budapest, Hungary.
Magy Onkol. 2018 Sep 26;62(3):169-174. Epub 2018 Jun 14.
Extended mandibular defects can be safely managed by applying microvascular free bone transfer. The flap of choice for this procedure is a fibula free flap due to its anatomical structure, proper length and good plasticity. The body of the mandible can be formed by removing wedge bone segments. However the gonial angle can be formed on a different, safer and easier way by performing axial osteotomy as it is done in the orthognathic surgery. The special advantage of this method is that by setting the exact angle of the ascending mandibular part, the ramus replacer fibula segment is perfectly suitable for the replacement of the head of the mandible. While recalling the anatomy of this region our clinical case demonstrates the functional reconstruction of these two delicate mandibular parts.
通过应用微血管游离骨移植可以安全地处理下颌骨的大范围缺损。由于其解剖结构、合适的长度和良好的可塑性，该手术首选的皮瓣是游离腓骨皮瓣。下颌骨体可以通过切除楔形骨段来形成。然而，通过进行正颌手术中所做的轴向截骨术，可以以一种不同的、更安全且更容易的方式形成下颌角。该方法的特殊优势在于，通过设定下颌升支部分的确切角度，腓骨替代支段非常适合替代下颌骨髁突。在回顾该区域的解剖结构时，我们的临床病例展示了这两个精细下颌部位的功能重建。
