Clinico-statistical Study on Reconstruction of the Mandible using the Bone Graft.
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概要
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In reconstruction of the mandible, the non-vascularized autogeneous iliac bone has been popularly used. Nowadays, the vascularized bones using microsurgery have many advantages over it.<BR>During twelve years, twenty-three patients underwent mandibular reconstruction using bone grafts. Donor sites included the vascularized fibula (9), non-vascularized ilium (6), radial forearm flap with hemi-radius (5), scapular osteocutaneous flap (1), pedicled rib-latissimus dorsi osteocutaneous flap (1), and reimplanted bone after freezing and warming (1).<BR>In 2 cases with the iliac bone graft, infection resulting from wound dehiscence occurred and was followed by great bone resorption. However, the grafted bone was not necessary to be removed.<BR>All but one microvascular transfers have been completely successful. In order to overcome the main disadvantage of the fibular graft, low vertical height of the bone, a "double barrel" fibula was used in five cases, and patients acquired good results esthetically and functionally.<BR>All patients with reconstructing marginal mandibulectomy, using the radial forearm flap, acquired good speech and oral function.<BR>Vascularized bone grafts had advantages over the conventional iliac bone graft in the major mandibular defect, especially in the irradiated cases. It is concluded that the vascularized fibular graft, especially a "double-barrel" fibula, is superior to any other method because of its length, great flexibility in shaping the bone using multiple osteotomies, and minimal donor-site morbidity, and that it is the first choice for major mandibular reconstruction. On the other hand, the radial forearm flap is more suitable in reconstruction of the partial thickness of the mandible containing the oral floor.
- 特定非営利活動法人 日本口腔科学会の論文
特定非営利活動法人 日本口腔科学会 | 論文
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