- Email: [email protected]
Prognoses of iliac bone grafts-postoperative complications of the donor sites
021-A Reconstructive surgery
10. Reconstruction of Hemifacial Atrophy
33
12. Myofascial flap without Skin in Intra-Oral Reconstruction
Takagi, T., Sagara, S. * Department of Plastic Surgery, Department of Oral Surgery, * Sumitomo Hospital We experienced three cases of hemifacial atrophy (Romberg's disease), One female and two male patients were operated on. Augmentation of facial soft tissue is required in Romberg's disease. One patient was treated by deepithelized free groin flap, and one patient was treated by deepithelized free flap and by facial bone osteotomy. One female patient was treated only by lipoinjection. Indeed, the augmentation of deepithelized flap provides a satisfactory solution to the problem of Romberg's disease; however, it is not sufficient. We propose that some patients need an osteotomy when an occlusal plane is not horizontal to the pupillary line. The importance of skeletal reconstruction should be emphasized in the corrective treatment of Romberg's disease.
11. Prognoses of Iliac Bone Grafts Postoperative Complications of the Donor Sites
Negishi, A., Fujinami, K., Ohara, M., Sato, R., Takaesu, 34., Asahiro, S., lijima, S., Kosaka, S., Marumo, A., Mishimagi, T., Noji, H., Sato, M., Yoshimasu, H., Amagasa, T. 1st Department OMS, Facl. Dent., Tokyo Med. Dent. Univ., Tokyo, Japan Iliac bone is frequently applied as a graft material for reconstruction of the oral and maxillofacial region because of its useful form, constitution, and characteristics. The corticocancellous bone block is employed for the reconstruction of the mandible after resection, and is grafted to the maxillary sinus wall to improve the mid-facial deformity caused by Le Fort I osteotomy. On the other hand, particulate cancellous bone marrow is transplanted to the alveolar cleft. It has been reported that taking the block sometimes has influence on walking due to disturbance of the donor site; however, taking the bone marrow rarely does. We examined the prognoses of 121 patients whose iliac bone was harvested between 1985 and 1996. Reconstruction of the mandible was applied in 21 tumor patients, augmentation of the mid-face in 39 facial deformity patients, and secondary bone graft in 61 cleft lip and palate patients. Corticocancellous bone blocks were obtained from 58 patients, and particulate cancellous bone marrow was harvested from 63 patients. Regarding the postoperative Complications in many patients, the pain in walking disappeared within 2 weeks, and the disability in walking diminished within 1 month. However, among them, some patients still had meralgia paresthetica. We report the postoperative complications of each harvesting method.
Wada, T., Okamoto, K., Nakanishi, Y., Hata, S., Morita, N., Sakamoto, T., Harada, M.* Department of Oral and Maxillofacial Surgery, Wakayama Medical College *Division of Oral and Maxillofacial Surgery, Kinan General Hospital The use of various skin flaps in the reconstruction of oral soft tissue defects has been reported. However, the use of skin in the oral cavity is worse than mucosa from the viewpoint of pliability and appendages such as hair sometimes appear in the mouth. Plain scar tissue is also often formed at the donor site. The aim of this study was to evaluate the possibility of using a myofascial graft in the oral cavity. Animal experiment: Wistar rats 6-8 weeks of age were used. Under general anesthesia, axial pattern myofascial flap of the latissimus muscle was prepared. The flap was then tunneled up into the neck and inserted into the oral mucosal defect. Wound closure was carried out using 5-0 nylon. Rats were sacrificed at a weekly interval to investigate the healing process of the grafted myofascial flap. It appeared that the myofascial flap covered the raw surface and induced epithelialization from the cutting edge of the normal mucosa. Clinical application: PM- or platysma-myofascial flaps were used in the reconstruction of soft tissue defects including the oral mucosa after resection of tumors of the oral cavity. Although the healing process was delayed, the surface of the grafted flap was completely covered by mucosa without scar formation.
13. The Application of Temporalis Muscle Flap in Intraoral Reconstruction After Tumor Surgery
Kok, S.-H., Lee, J.-J., Kuo, Y-S., Yang, P.-J., Hahn, L.*J. Division of Oral and Maxillofaeial Surgery, Department of Dentistry, National Taiwan University Hospital, Mairei, Taiwan, ROC Reconstruction after tumor resection in the oral and maxillofaeial region has long been a challenge to the surgeons. In order to rehabilitate the patients functionally and aesthetically, many flaps have been developed. Different types of flaps have different characteristics and their own advantages and disadvantages. For intraoral reconstruction, temporalis muscle flap has the advantage of having adequate thickness, good pliability, no hair and close proximity to the oral cavity. Flap elevation and suturing in the recipient site is simple. No significant donor site morbidity is known aside from a depression in the temporal area that can easily be camouflaged with hair. The mouth opening is generallly unaltered by this procedure. Seven patients in whom reconstruction with temporalis
10. Reconstruction of Hemifacial Atrophy
33
12. Myofascial flap without Skin in Intra-Oral Reconstruction
Takagi, T., Sagara, S. * Department of Plastic Surgery, Department of Oral Surgery, * Sumitomo Hospital We experienced three cases of hemifacial atrophy (Romberg's disease), One female and two male patients were operated on. Augmentation of facial soft tissue is required in Romberg's disease. One patient was treated by deepithelized free groin flap, and one patient was treated by deepithelized free flap and by facial bone osteotomy. One female patient was treated only by lipoinjection. Indeed, the augmentation of deepithelized flap provides a satisfactory solution to the problem of Romberg's disease; however, it is not sufficient. We propose that some patients need an osteotomy when an occlusal plane is not horizontal to the pupillary line. The importance of skeletal reconstruction should be emphasized in the corrective treatment of Romberg's disease.
11. Prognoses of Iliac Bone Grafts Postoperative Complications of the Donor Sites
Negishi, A., Fujinami, K., Ohara, M., Sato, R., Takaesu, 34., Asahiro, S., lijima, S., Kosaka, S., Marumo, A., Mishimagi, T., Noji, H., Sato, M., Yoshimasu, H., Amagasa, T. 1st Department OMS, Facl. Dent., Tokyo Med. Dent. Univ., Tokyo, Japan Iliac bone is frequently applied as a graft material for reconstruction of the oral and maxillofacial region because of its useful form, constitution, and characteristics. The corticocancellous bone block is employed for the reconstruction of the mandible after resection, and is grafted to the maxillary sinus wall to improve the mid-facial deformity caused by Le Fort I osteotomy. On the other hand, particulate cancellous bone marrow is transplanted to the alveolar cleft. It has been reported that taking the block sometimes has influence on walking due to disturbance of the donor site; however, taking the bone marrow rarely does. We examined the prognoses of 121 patients whose iliac bone was harvested between 1985 and 1996. Reconstruction of the mandible was applied in 21 tumor patients, augmentation of the mid-face in 39 facial deformity patients, and secondary bone graft in 61 cleft lip and palate patients. Corticocancellous bone blocks were obtained from 58 patients, and particulate cancellous bone marrow was harvested from 63 patients. Regarding the postoperative Complications in many patients, the pain in walking disappeared within 2 weeks, and the disability in walking diminished within 1 month. However, among them, some patients still had meralgia paresthetica. We report the postoperative complications of each harvesting method.
Wada, T., Okamoto, K., Nakanishi, Y., Hata, S., Morita, N., Sakamoto, T., Harada, M.* Department of Oral and Maxillofacial Surgery, Wakayama Medical College *Division of Oral and Maxillofacial Surgery, Kinan General Hospital The use of various skin flaps in the reconstruction of oral soft tissue defects has been reported. However, the use of skin in the oral cavity is worse than mucosa from the viewpoint of pliability and appendages such as hair sometimes appear in the mouth. Plain scar tissue is also often formed at the donor site. The aim of this study was to evaluate the possibility of using a myofascial graft in the oral cavity. Animal experiment: Wistar rats 6-8 weeks of age were used. Under general anesthesia, axial pattern myofascial flap of the latissimus muscle was prepared. The flap was then tunneled up into the neck and inserted into the oral mucosal defect. Wound closure was carried out using 5-0 nylon. Rats were sacrificed at a weekly interval to investigate the healing process of the grafted myofascial flap. It appeared that the myofascial flap covered the raw surface and induced epithelialization from the cutting edge of the normal mucosa. Clinical application: PM- or platysma-myofascial flaps were used in the reconstruction of soft tissue defects including the oral mucosa after resection of tumors of the oral cavity. Although the healing process was delayed, the surface of the grafted flap was completely covered by mucosa without scar formation.
13. The Application of Temporalis Muscle Flap in Intraoral Reconstruction After Tumor Surgery
Kok, S.-H., Lee, J.-J., Kuo, Y-S., Yang, P.-J., Hahn, L.*J. Division of Oral and Maxillofaeial Surgery, Department of Dentistry, National Taiwan University Hospital, Mairei, Taiwan, ROC Reconstruction after tumor resection in the oral and maxillofaeial region has long been a challenge to the surgeons. In order to rehabilitate the patients functionally and aesthetically, many flaps have been developed. Different types of flaps have different characteristics and their own advantages and disadvantages. For intraoral reconstruction, temporalis muscle flap has the advantage of having adequate thickness, good pliability, no hair and close proximity to the oral cavity. Flap elevation and suturing in the recipient site is simple. No significant donor site morbidity is known aside from a depression in the temporal area that can easily be camouflaged with hair. The mouth opening is generallly unaltered by this procedure. Seven patients in whom reconstruction with temporalis