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Experimental and clinical studies of osteosynthesized mandibular condyle fractures using a bioabsorbable PLLA pin and plate
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028B - Maxillofacial reconstruction
15. Experimental and Clinical Studies of Osteosynthesized Mandibular Condyle Fractures Using a Bioabsorbable PLLA Pin and Plate
16. Reconstruction of Extended Perforated Defects in the Oral and Maxillofacial Region with Dual Flaps
Shen, (Yr., Tang, Y, Zhang, Z., Qiu, W. Noguchi, L, Sato, Y, Ando, T., Tkahashi, M., Kurokawa, H., Kimijima, Y, Miyashita, N., Hasegawa, Y
University of Hong Kong, Hong Kong SAR, Peoples Republic of China
Department of Oral and Maxillofacial Surgery, National Defense Medical College, Saitama, Japan Aims This study examined the histologic reaction to P L L A pins used for osteosynthesis of condylectomy in mini-pigs and evaluated the clinical use of osteosynthesis with P L L A pins for fracture of the mandibular condyle; in addition, mandibular movement, masticatory function and bite pressure were tested in patients postoperatively. Materials and methods Absorbable P L L A pins ( N E O F I X | measuring 2.0 ram• 5.0 mm were inserted at the inferior border of the mandible through the mandibular ramus to the reduced condyle fragment. The PLLA plates were secured to stabilize the reconstructed segments to the mandibular ramus. Osteosynthesis after condylectomy and histological reactions were observed macroscopically in five (6site) mini-pigs after sacrifice at 2, 4, 8, 12, 16, and 20 weeks postoperatively. Finally, ten patients were tested postperatively for mandibular movement, masticatory function and bite pressure using MkG, low-adhesive color-developing chewing gum, and a bite pressure instrument, respectively, and results were compared with those in controls (n=23, 20, 17). Results The mean maximum mandible opening was 51.4-+6.8 mm in controls (n=23), and in 4 patients 28.6-+5.8 mm at less than 6 months postoperatively and 40.3-+3.2 mm at more than 6 months. The change observed in the patients was significant. The mean chewing efficiency was 45.0+4.9 in 20 controls and 42.2-+6.1 mm in 8 patients at 3-72 weeks postoperatively. The mean occlusal force was 28.1 -+ 13.4 mm in 17 controls and 23.3-+5.8 mm in 6 patients at 3-32 weeks postoperatively. Macroscopic osteosynthesis after condylectomy in mini-pigs was achieved within the first 2 weeks postoperatively. A small amount of bone was observed histologically surrounding the P L L A pin at 2 weeks postoperatively, and a large amount of bone was seen at 4 weeks and a high density of bone was observed at 8 and 12 weeks. Conclusions Long-term strong osteosynthesis was obtained using the P L L A pin and plate for fixation of condylar fracture of the mandible.
In this retrospective study, 40 patients with extended perforated maxillofacial and/or mouth-floor defect following ablative cancer surgery were reconstructed by means of combined revascularized forearm flap and pedicled pectoral major myocutaneous flap. A total of 30 flaps were used with a successful survival rate of 100%. Satisfied maxillofacial appearance and stomatognathic function was achieved. Conclusion It is a reasonable method to use combined revascularized forearm flap with pedicled pectoral major myocutaneous flap for the reconstruction of extended perforated maxillofacial and/or mouth-floor defect following ablative surgery of advanced tumor.
17. The Transconjunctival Incision with Lateral Canthotomy: A Prospective Study of Fifty Patients
Sneddon, K., Moody, A., Avery, C. Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex, England The increasing emphasis on the open reduction and fixation and internal fixation of zygomatic complex fractures has led to a more critical appraisal of the various surgical approaches to the orbital skeleton. Those in most common usage are the subciliary described by Converse in 1944 and the transconjunctival popularized by Tessier although credited to Bourquet in 1924. Both offer excellent exposure of the inferior orbital rim and floor. When fixation is required at the fronto-zygomatic suture, an additional and separate approach is required. A single cosmetic incision holds many attractions and Manson in 1987 described his experience of either a subciliary or transconjunctival incision in conjunction with a lateral canthotomy. We report a prospective study in which 50 patients have undergone fracture repair via a transconjunctival incision in combination with a lateral canthotomy. In all patients, excellent surgical exposure has been achieved with the advantage over other approaches of allowing simultaneous visualization of both the inferior orbital rim and the F Z suture. All cases have been followed up for a minimum of three months. Clinically noted complications have been documented. Changes in our operative technique based on our early results are described. Our rates of ectropion and scleral favorably compare with other published series.
028B - Maxillofacial reconstruction
15. Experimental and Clinical Studies of Osteosynthesized Mandibular Condyle Fractures Using a Bioabsorbable PLLA Pin and Plate
16. Reconstruction of Extended Perforated Defects in the Oral and Maxillofacial Region with Dual Flaps
Shen, (Yr., Tang, Y, Zhang, Z., Qiu, W. Noguchi, L, Sato, Y, Ando, T., Tkahashi, M., Kurokawa, H., Kimijima, Y, Miyashita, N., Hasegawa, Y
University of Hong Kong, Hong Kong SAR, Peoples Republic of China
Department of Oral and Maxillofacial Surgery, National Defense Medical College, Saitama, Japan Aims This study examined the histologic reaction to P L L A pins used for osteosynthesis of condylectomy in mini-pigs and evaluated the clinical use of osteosynthesis with P L L A pins for fracture of the mandibular condyle; in addition, mandibular movement, masticatory function and bite pressure were tested in patients postoperatively. Materials and methods Absorbable P L L A pins ( N E O F I X | measuring 2.0 ram• 5.0 mm were inserted at the inferior border of the mandible through the mandibular ramus to the reduced condyle fragment. The PLLA plates were secured to stabilize the reconstructed segments to the mandibular ramus. Osteosynthesis after condylectomy and histological reactions were observed macroscopically in five (6site) mini-pigs after sacrifice at 2, 4, 8, 12, 16, and 20 weeks postoperatively. Finally, ten patients were tested postperatively for mandibular movement, masticatory function and bite pressure using MkG, low-adhesive color-developing chewing gum, and a bite pressure instrument, respectively, and results were compared with those in controls (n=23, 20, 17). Results The mean maximum mandible opening was 51.4-+6.8 mm in controls (n=23), and in 4 patients 28.6-+5.8 mm at less than 6 months postoperatively and 40.3-+3.2 mm at more than 6 months. The change observed in the patients was significant. The mean chewing efficiency was 45.0+4.9 in 20 controls and 42.2-+6.1 mm in 8 patients at 3-72 weeks postoperatively. The mean occlusal force was 28.1 -+ 13.4 mm in 17 controls and 23.3-+5.8 mm in 6 patients at 3-32 weeks postoperatively. Macroscopic osteosynthesis after condylectomy in mini-pigs was achieved within the first 2 weeks postoperatively. A small amount of bone was observed histologically surrounding the P L L A pin at 2 weeks postoperatively, and a large amount of bone was seen at 4 weeks and a high density of bone was observed at 8 and 12 weeks. Conclusions Long-term strong osteosynthesis was obtained using the P L L A pin and plate for fixation of condylar fracture of the mandible.
In this retrospective study, 40 patients with extended perforated maxillofacial and/or mouth-floor defect following ablative cancer surgery were reconstructed by means of combined revascularized forearm flap and pedicled pectoral major myocutaneous flap. A total of 30 flaps were used with a successful survival rate of 100%. Satisfied maxillofacial appearance and stomatognathic function was achieved. Conclusion It is a reasonable method to use combined revascularized forearm flap with pedicled pectoral major myocutaneous flap for the reconstruction of extended perforated maxillofacial and/or mouth-floor defect following ablative surgery of advanced tumor.
17. The Transconjunctival Incision with Lateral Canthotomy: A Prospective Study of Fifty Patients
Sneddon, K., Moody, A., Avery, C. Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex, England The increasing emphasis on the open reduction and fixation and internal fixation of zygomatic complex fractures has led to a more critical appraisal of the various surgical approaches to the orbital skeleton. Those in most common usage are the subciliary described by Converse in 1944 and the transconjunctival popularized by Tessier although credited to Bourquet in 1924. Both offer excellent exposure of the inferior orbital rim and floor. When fixation is required at the fronto-zygomatic suture, an additional and separate approach is required. A single cosmetic incision holds many attractions and Manson in 1987 described his experience of either a subciliary or transconjunctival incision in conjunction with a lateral canthotomy. We report a prospective study in which 50 patients have undergone fracture repair via a transconjunctival incision in combination with a lateral canthotomy. In all patients, excellent surgical exposure has been achieved with the advantage over other approaches of allowing simultaneous visualization of both the inferior orbital rim and the F Z suture. All cases have been followed up for a minimum of three months. Clinically noted complications have been documented. Changes in our operative technique based on our early results are described. Our rates of ectropion and scleral favorably compare with other published series.