Biswas Gautam
Department of Plastic and Reconstructive Surgery, TATA Medical Center, Kolkata, West Bengal, India.
Indian J Plast Surg. 2020 Dec;53(3):324-334. doi: 10.1055/s-0040-1721870. Epub 2020 Dec 31.
Reconstruction of the complex anatomy and aesthetics of the midface is often a challenge. A careful understanding of this three-dimensional (3D) structure is necessary. Anticipating the extent of excision and its planning following oncological resections is critical. In the past over two decades, with the advances in microsurgical procedures, contributions toward the reconstruction of this area have generated interest. Planning using digital imaging, 3D printed models, osseointegrated implants, and low-profile plates, has favorably impacted the outcome. However, there are still controversies in the management: to use single composite tissues versus multiple tissues; implants versus autografts; vascularized versus nonvascularized bone; prosthesis versus reconstruction. This article explores the present available options in maxillary reconstruction and outlines the approach in the management garnered from past publications and experiences.
重建面中部复杂的解剖结构和美学效果往往具有挑战性。必须仔细了解这种三维(3D)结构。在肿瘤切除术后预估切除范围并进行规划至关重要。在过去的二十多年里,随着显微外科手术的进步,对该区域重建的贡献引发了人们的兴趣。使用数字成像、3D打印模型、骨整合植入物和薄型钢板进行规划,对手术结果产生了积极影响。然而,在治疗方法上仍存在争议:使用单一复合组织还是多种组织;植入物还是自体移植;带血管蒂骨还是非带血管蒂骨;假体还是重建。本文探讨了目前上颌骨重建的可用选项,并概述了从以往文献和经验中总结出的治疗方法。