Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Craniofac Surg. 2020 Sep;31(6):1768-1772. doi: 10.1097/SCS.0000000000006578.
Autogenous bone is the best material in cranioplasty because of biological advantages. Previously, skull, rib, ilium, and fibula have been used in the reconstruction of cranial defects. However, the application of autologous mandibular outer plate in the treatment of skull defect is rarely reported. This study evaluated the application of the autogenous mandibular outer plate in the reconstruction of cranial defect.
Eleven patients who underwent cranioplasty with mandibular outer plate were recruited. Three-dimensional tomography data were collected to calculate the preoperative, immediate postoperative, and long-term follow-up volume of the bone graft area and donor bone site, and then the absorption rate and the regeneration rate of autogenous bone were analyzed.
The majority of the patients were satisfied with the reconstructive outcome. There are statistical differences in the volumetric measurements of the bone graft area and bone donor site at different time periods (P<0.05). The mean absorptivity of mandibular outer plate implanted in the cranial defect area was (17.30 ± 5.03)% after 3 to 24 months postoperatively, the average regeneration rate of mandibular outer plate volume was (41.65 ± 9.85)% at the same period.
This report shows that the cranioplasty with mandibular outer plate bone graft may be an optional surgical procedure.
自体骨具有生物优势，是颅骨修补的最佳材料。此前，颅骨、肋骨、髂骨和腓骨已被用于重建颅面缺损。然而，自体下颌骨外板在颅骨缺损治疗中的应用却鲜有报道。本研究评估了自体下颌骨外板在颅骨缺损重建中的应用。
共纳入 11 例行颅骨修补术并采用下颌骨外板的患者。采集三维断层扫描数据，计算术前、即刻术后和长期随访时骨移植区和供骨区的体积，并分析自体骨的吸收率和再生率。
大多数患者对重建效果满意。不同时期的骨移植区和供骨区的体积测量结果存在统计学差异（P<0.05）。术后 3 至 24 个月，下颌骨外板植入颅骨缺损区的平均吸收率为（17.30±5.03）%，同期下颌骨外板体积的平均再生率为（41.65±9.85）%。
本报告表明，下颌骨外板骨移植颅骨修补术可能是一种可选的手术方法。
