A case of mandibular osteoradionecrosis caused after treating cancer of the pharynx, larynx and esophagus reconstructed by titanium mesh tray with autogenous bone graft and D-P flap.
スポンサーリンク
概要
- 論文の詳細を見る
This is a report on a case of reconstructed mandibular osteoradionecrosis. Mandible and oro-cutaneous fistula were both repaired by titanium mesh tray with autogenous bone graft and D-P flap. The patient was a 57-year-old maie who had been operated on for a tumor of the hypopharynx, larynx and esophagus and was given radiation therapy at a total dose of 120 Gy on the face and neck from July 1980 to September 1983. There was an oro-cutaneous fistula on the right submandibular portion, and there also existed a pathologic fracture at the right side of the mandible.<BR>A D-P flap was introduced in this case to close the oro-cutaneous fistula. Delay was made on the deltoid portion of the flap to confirm blood supply into it; three weeks later, the free end of the flap was sutured to the right submandibular portion. The D-P flap was severed at 14 cm from the suture after another three weeks. At that time the flap was rotated and the severed end was sutured to the posterior portion of the submandibular region to form a pedicle flap. A month later, the mandible, including the sequestra, was segmentally resected, and the separated mandibular bone was temporarilly fixed by Roger Anderson's equipment. The mucosal defect was then closed by the posterior portion of the pedicle flap, which was cut at 4.5cm from the anterior end. After a confirmation of the complete closure of the orocutaneous fistula, Roger Anderson's equipment was then replaced by an A-O plate. The facial skin defect was thereupon restored with the remaining parts of the pedicle flaps. Seven months later, the mandible was finally reconstructed with a titanium mesh tray and an autogenous iliac bone graft into it. By these procedures, the patient managed to recover his normal masticatory function.<BR>The etiology of mandibular osteoradionecrosis complicated by the radiation therapy of oral cancer and difficulty of the surgical treatment are discussed.
- 一般社団法人 日本口腔腫瘍学会の論文
一般社団法人 日本口腔腫瘍学会 | 論文
- 進行口腔癌に対する逆行性超選択的動注化学療法, 放射線同時併用療法後の救済手術
- TS-1による化学療法と温熱放射線療法が著効した後発頸部リンパ節転移の1例
- 手術シミュレーションに基づく腫瘍分割摘出により顎骨を保存した得た下顎骨骨形成線維腫の1例
- 口腔癌における化学・放射線療法後の再発・二次再建に関する外科療法の検討
- 下顎骨再建 : 血管柄付遊離骨移植と遊離軟部組織移植の比較