Friedrich R E, Hellner D, Plambeck K, Schmelzle R
Klinik für Mund-, Kiefer- und Gesichtschirurgie-Nordwest-deutsche Kieferklinik, Universitäts-Krankenhaus Eppendorf, Universität Hamburg.
Ultraschall Med. 1997 Aug;18(4):177-81. doi: 10.1055/s-2007-1000421.
B-scan ultrasonography (US) was applied in patients subjected to callus distraction for bone formation at the interface of mandibular segments and vascularised bone grafts.
This study consisted of 7 patients requiring further surgical augmentation to allow for prosthetic treatment. All patients had been preoperatively irradiated percutaneously in the region of the primary oral squamous cell carcinoma up to an isodose of 60-75.5 Gy. Ablative surgery was then performed, including discontinuity resection of the mandible. Vascularised iliac crest grafts had been chosen due to poor healing conditions in the irradiated recipient site. For callus distraction, a distraction device was inserted in both the mandibular segment and the bone graft. Subsequently, osteotomy was performed, and distracting forces were applied to the segments. For US, a small-part applicator was used (7.5 MHz).
US gives a true estimation of the distraction length, actually achieved at the time of investigation. The applicator can be easily adjusted to the area of interest. Application is safe and easy, the results are reliable, and the procedure can be carried out without affecting the hygiene of the wound after surgical intervention. In addition, US enables the supervising surgeon to detect zones of calcification in the area of callus distraction at an earlier point than can be detected by standard x-ray documentation, thus facilitating control of the therapy.
US is highly recommended for routine application in callus distraction of the mandible. X-ray documentation is a "must".
将B超超声检查（US）应用于接受骨痂牵张术以促进下颌骨节段与带血管骨移植界面处骨形成的患者。
本研究包括7例需要进一步手术增强以便进行修复治疗的患者。所有患者术前均在原发性口腔鳞状细胞癌区域经皮进行了照射，等剂量达60 - 75.5 Gy。随后进行了切除手术，包括下颌骨的间断性切除。由于受照受体部位愈合条件差，选择了带血管的髂嵴移植。对于骨痂牵张，在下颌骨节段和骨移植处均插入了牵张装置。随后进行截骨术，并对节段施加牵张力。对于超声检查，使用了小型探头（7.5 MHz）。
超声能真实估计在检查时实际实现的牵张长度。探头可轻松调整至感兴趣区域。应用安全简便，结果可靠，且该操作可在不影响手术干预后伤口卫生的情况下进行。此外，与标准X线记录相比，超声能使主刀医生更早地检测到骨痂牵张区域的钙化区域，从而便于控制治疗。
强烈推荐超声在颌骨骨痂牵张中常规应用。X线记录是“必需的”。
