Dupoirieux L, Siciliano S, Savastano G, Souyris F
Service de Chirurgie Maxillo-Faciale et Plastique de la Face, Faculté de Medicine Universite de Montpellier, France.
Minerva Stomatol. 1994 Nov;43(11):507-12.
Popularized by Tessier in 1982, the calvarial bone graft has been used extensively in reconstructive techniques in the cranio-facial region. The authors present here their experience of nasal bone grafting using split skull grafts for post-traumatic reconstructions. Ten patients, with a total of 11 bone grafts harvested, were operated. Results are reported. The level of patient satisfaction has been high. We have had only 2 minor complications, 1 case of alopecia, corrected by a resection in local anesthesia, this inconvenient has never reported before in the literature, and another case of secondary displacement of the nasal bone graft, who required a second operation with a good result. Discussion is reported. Several methods have been used for nasal reconstruction as silicone implants and other bone donor site; but they have disadvantages like painful to the donor site, long hospitalizations, infections and extrusions, etc. The use of cranial graft has some advantages: first of all, it is less likely to resorb, because of its membranous origin, the donor site is in close proximity to the area to be grafted, there is almost no morbidity to the donor site. Recently two case reports describing major complications were published in the literature. A case of a superior sagittal sinus laceration reported by Cannella and Hopkins and a case of an intracerebral hematoma, reported by Leroy-Young. For these reasons it's important to follow strictly the surgical procedure described. We recommended this technique only to those surgeons who are experienced in cranio-facial surgery.
1982年由泰西埃推广的颅骨移植，已在颅面区域的重建技术中广泛应用。作者在此介绍他们使用劈开颅骨移植进行鼻骨移植以修复创伤后畸形的经验。对10例患者进行了手术，共采集了11块骨移植材料，并报告了结果。患者满意度较高。我们仅出现了2例轻微并发症，1例脱发，在局部麻醉下通过切除术得以纠正，这种情况在文献中此前从未有过报道；另1例鼻骨移植继发移位，需再次手术，效果良好。文中进行了讨论。鼻重建已采用多种方法，如硅胶植入物及其他骨供区；但它们存在一些缺点，如供区疼痛、住院时间长、感染及植入物挤出等。使用颅骨移植有一些优点：首先，由于其膜性起源，其吸收的可能性较小，供区与移植区域相邻，供区几乎无并发症。最近文献发表了两篇描述严重并发症的病例报告。一篇是卡内拉和霍普金斯报道的上矢状窦撕裂病例，另一篇是勒罗伊 - 扬报道的脑内血肿病例。出于这些原因，严格遵循所描述的手术步骤很重要。我们仅向那些有颅面外科经验的外科医生推荐这项技术。
