自家遊離腸骨移植による下顎再建とその術後経過について

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From November 1974 to April 1986, 34 cases (36 operations) of mandibular reconstruction using iliac bone graft were performed in our department. They included 16 cases of ameloblastoma, 8 cases of carcinoma of the mandible, 5 cases of carcinoma of the floor of the mouth, 2 cases of ossifying fibroma, 2 cases of mucoepidermoid tumor of the mandible, and one case of primordial cyst.<BR>In twenty operations, mandibular reconstruction was conducted simultaneously with mandibular resection. In the other 16 operations, mandibular reconstruction was performed 3 to 6 months after mandibular resection (including 2 secondary reconstructions after failure of immediate reconstruction). A metal plate was used on grafted bone and the residual mandibular fragments fixed rigidly except for two cases where interosseous wiring was used.<BR>Good prognoses were gained in this series, but the grafted bone was removed in 4 cases because of infection. In all of these cases, immediate reconstruction after segmental resection of the mandible had been performed.<BR>In 24 cases, we observed absorption of the grafted bone over time after surgery using orthopantomography. Minimal absorption was observed in 11 cases, moderate bone absorption in 9 cases and in 4 cases severe bone absorption was observed. In bridging bone grafts which spanned the residual fragments after segmental resection of the mandible, minimal bone absorption was generally observed, but in free-end bone grafts after hemimandiblectomy, moderate or severe bone absorption occurred except for one case in which the grafted bone had been wrapped with the periosteum.

自家遊離腸骨移植による下顎再建とその術後経過について

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