Sood Rachita, Froimson Jill R, Reid Russell R
University of Chicago Medicine.
University of Chicago Biological Sciences Division, Chicago, IL.
J Craniofac Surg. 2025;36(1):e41-e43. doi: 10.1097/SCS.0000000000010719. Epub 2024 Oct 7.
Ballistic facial trauma can cause complex fractures and overlying soft tissue damage, with a zone of injury that extends beyond the bullet tract. Early skeletal fixation is indicated, and previous large case series describe the use of debrided bone fragments as 'spare part' grafts. This series presents the indications and techniques for simultaneous coronoid bone grafting in 2 patients who sustained a gunshot wound to the right midface and required coronoidectomy. The coronoid process was used as (1) an interposition graft in the lateral buttress of the right maxilla for stability, and (2) an onlay graft on the right inferior orbital rim for contour. Both patients did not have graft infection, extrusion, or malposition at the 1-month clinic follow-up. The coronoid process of the mandible is a viable, safe spare-part option, despite the possible location of the coronoid process within the zone of injury in the reconstruction of complex ballistic facial trauma.
弹道性面部创伤可导致复杂骨折和覆盖的软组织损伤，损伤区域超出子弹弹道范围。早期进行骨骼固定是必要的，以往的大型病例系列描述了使用清创后的骨碎片作为“备用”移植物。本系列介绍了2例右侧面中部遭受枪伤并需要进行冠突切除术的患者同时进行冠突骨移植的适应证和技术。冠突被用作：（1）置于右上颌骨外侧支柱的植入性移植物以提供稳定性，以及（2）置于右下眼眶缘的贴附性移植物以塑造外形。在1个月的门诊随访中，两名患者均未出现移植物感染、挤出或位置不当的情况。尽管在复杂弹道性面部创伤重建中，冠突可能位于损伤区域内，但下颌骨冠突仍是一种可行、安全的备用选择。
