Department of Plastic, Reconstructive and Aesthetic Surgery, Selcuk University Faculty of Medicine, Konya, Turkey.
Department of Plastic, Reconstructive and Aesthetic Surgery, Selcuk University Faculty of Medicine, Konya, Turkey.
J Plast Reconstr Aesthet Surg. 2022 Oct;75(10):3768-3773. doi: 10.1016/j.bjps.2022.06.040. Epub 2022 Jun 23.
Alveolar cleft reconstruction is important to increase the quality of life of cleft lip and palate patients. Usually, alveolar clefts can be reconstructed using bone grafts. However, bone grafting can be insufficient, and other alternatives may be necessary in wide and recalcitrant clefts. The medial femoral condyle (MFC) flap may be the solution for alveolar clefts that are impossible to reconstruct with bone grafting. In this study, the reconstruction of alveolar clefts in the pediatric cleft lip and palate population, using the MFC flap, is described. This study examined 9 pediatric patients whose alveolar clefts were reconstructed prospectively using MFC flap in 2015 and 2019. The age, gender, follow-up times, independent parameters, and existence of concomitant vestibulonasal fistulas of the patients were recorded. Computerized tomography images of the patients were evaluated to detect defect characteristics and evaluate the volume of flap postoperatively. Flap viability was confirmed with bone scintigraphy, and donor area morbidity was evaluated with the Dynamic Gait Index (DGI) in the postoperative period. The study included 7 male and 2 female patients. The mean age of the patients was 13. In addition to an alveolar cleft, 6 patients also had vestibulonasal fistula. It was observed that the volume of the flaps had not changed one year after the operation. The DGI score of all the patients was 24. Existing techniques may be inadequate in the reconstruction of wide and recalcitrant alveolar clefts. MFC flap may be the start of a new era for the treatment of alveolar clefts.
牙槽裂重建对于提高唇腭裂患者的生活质量至关重要。通常，牙槽裂可以通过植骨来重建。然而，植骨可能不足，在广泛和顽固的牙槽裂中可能需要其他替代方法。股内侧髁（MFC）瓣可能是无法通过植骨重建的牙槽裂的解决方案。在本研究中，描述了使用 MFC 瓣重建小儿唇腭裂患者的牙槽裂。本研究检查了 2015 年和 2019 年使用 MFC 瓣前瞻性重建牙槽裂的 9 名小儿患者。记录了患者的年龄、性别、随访时间、独立参数以及是否存在伴发的前庭鼻腔瘘。对患者的计算机断层扫描图像进行评估，以检测缺陷特征，并评估术后瓣的体积。使用骨闪烁扫描确认瓣的存活，并在术后使用动态步态指数（DGI）评估供区的发病率。该研究包括 7 名男性和 2 名女性患者。患者的平均年龄为 13 岁。除牙槽裂外，6 名患者还有前庭鼻腔瘘。术后一年观察到瓣的体积没有变化。所有患者的 DGI 评分均为 24。现有的技术在重建广泛和顽固的牙槽裂时可能不足。MFC 瓣可能为牙槽裂的治疗开创一个新时代。
