Cook D W, Winek T, Yeager R, Olivier T, McConnell D, Sasaki T
Department of Surgery, Portland Veterans Administration Medical Center, OR 97207.
Laryngoscope. 1988 Mar;98(3):349-52. doi: 10.1288/00005537-198803000-00023.
Mandibular reconstruction in an irradiated field continues to be a challenge to the reconstructing surgeon. Several methods use rib grafts to bring vascularized tissue to the mandibular region. A median sternotomy provides excellent exposure to harvest the internal mammary artery and anterior axial rib graft for subsequent mandibular reconstruction. The modified technique described provides an alternative method of bringing a vascularized rib graft to an irradiated field for mandibular reconstruction avoiding multiple rib resections and microvascular anastomosis. This technique has been used in two patients who had anterior mandibular resection and irradiation therapy for advanced squamous cell carcinoma. The results from this technique were excellent and without major complications.
在放疗区域进行下颌骨重建对重建外科医生来说仍然是一项挑战。有几种方法使用肋骨移植来将带血管组织带到下颌骨区域。正中胸骨切开术能提供极佳的暴露，以便获取胸廓内动脉和前轴肋骨移植片用于后续的下颌骨重建。所描述的改良技术提供了一种将带血管肋骨移植片带到放疗区域进行下颌骨重建的替代方法，避免了多处肋骨切除和微血管吻合。该技术已应用于两名因晚期鳞状细胞癌接受下颌骨前部切除和放射治疗的患者。这项技术的效果极佳且无重大并发症。
