Kellman R M
Department of Otolaryngology, State University of New York Health Science Center, New York.
Arch Otolaryngol Head Neck Surg. 1994 Aug;120(8):856-60. doi: 10.1001/archotol.1994.01880320058013.
A review of a new technique for the harvesting of split (outer-table) calvarial bone grafts is presented. The use of calvarial bone grafts for facial reconstructive surgery has become more commonplace in recent years. Low donor site morbidity and availability of adequate amounts of membranous bone in close proximity to the facial surgical site make its use particularly desirable. Unfortunately, the occasional complications associated with the harvesting of these grafts can be severe, including dural tears and/or hemorrhage from a dural sinus, as well as late hematomas and meningitis. The technique herein described involves the use of a long malleable blade in a reciprocating saw. The malleability of the blade allows it to conform to the shape of the skull while elevating split grafts almost as wide as the blade is long. Twenty separate grafts were harvested in 18 patients. The largest measured 7 x 10 cm. The grafts were further contoured after harvesting and used in 37 sites. No grafts splintered, and no donor site complications were encountered. While care must of course be exercised with any technique, this one is believed to be a safe and dependable method for the harvesting of split calvarial grafts for facial reconstruction.
本文介绍了一种用于获取劈开（外板）颅骨骨移植的新技术。近年来，颅骨骨移植在面部重建手术中的应用变得更为普遍。供区发病率低，且在面部手术部位附近可获得足够数量的膜性骨，使其应用特别理想。不幸的是，获取这些移植物偶尔会出现严重并发症，包括硬脑膜撕裂和/或硬脑膜窦出血，以及迟发性血肿和脑膜炎。本文所述技术涉及在往复锯中使用长的可塑形刀片。刀片的可塑形性使其在抬起几乎与刀片长度一样宽的劈开移植物时能够贴合颅骨形状。在18例患者中获取了20块独立的移植物。最大的尺寸为7×10厘米。移植物在获取后进一步塑形，并用于37个部位。没有移植物出现碎裂，也未遇到供区并发症。当然，无论采用何种技术都必须谨慎操作，但据信这种技术是一种安全可靠的获取劈开颅骨移植物用于面部重建的方法。
