节段性下颌骨缺损的重建：当前手术方法与展望。
Reconstruction of segmental mandibular defects: Current procedures and perspectives.
作者信息
Paré Arnaud, Bossard Adeline, Laure Boris, Weiss Pierre, Gauthier Olivier, Corre Pierre
机构信息
Service de Chirurgie Maxillo Faciale Plastique et Brulés, Hôpital Trousseau, CHU de Tours Tours France.
Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.
出版信息
Laryngoscope Investig Otolaryngol. 2019 Nov 22;4(6):587-596. doi: 10.1002/lio2.325. eCollection 2019 Dec.
BACKGROUND
The reconstruction of segmental mandibular defects remains a challenge for the reconstructive surgeon, from both a functional and an esthetic point of view.
METHODS
This clinical review examines the different techniques currently in use for mandibular reconstruction as related to a range of etiologies, including the different bone donor sites, the alternatives to free flaps (FFs), as well as the contribution of computer-assisted surgery. Recent progress and the perspectives in bone tissue engineering (BTE) are also discussed.
RESULTS
Osseous FF allows reliable and satisfying outcomes. However, locoregional flap, distraction osteogenesis, or even induced membrane techniques are other potential options in less favorable cases. Obtaining an engineered bone with satisfactory mechanical properties and sufficient vascular supply requires further investigations.
CONCLUSIONS
Osseous FF procedure remains the gold standard for segmental mandible reconstruction. BTE strategies offer promising alternatives.
背景
从功能和美学角度来看，节段性下颌骨缺损的重建对重建外科医生而言仍是一项挑战。
方法
本临床综述探讨了目前用于下颌骨重建的不同技术，这些技术与一系列病因相关，包括不同的骨供区、游离皮瓣（FF）的替代方法以及计算机辅助手术的作用。还讨论了骨组织工程（BTE）的最新进展和前景。
结果
骨游离皮瓣可实现可靠且令人满意的效果。然而，在不太有利的情况下，局部皮瓣、牵张成骨甚至诱导膜技术也是其他潜在选择。获得具有令人满意的力学性能和充足血供的工程骨仍需进一步研究。
结论
骨游离皮瓣手术仍是节段性下颌骨重建的金标准。骨组织工程策略提供了有前景的替代方法。
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