Jaw in a Day: State of the Art in Maxillary Reconstruction.
Jaw in a Day: State of the Art in Maxillary Reconstruction.
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DOI：
10.1097/scs.0000000000003139
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Hirsch DL
中科院分区：
文献类型：
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作者：
Runyan CM;Sharma V;Staffenberg DA;Levine JP;Brecht LE;Wexler LH;Hirsch DL
上颌肿瘤切除后缺损的重建是具有挑战性的，因为上颌的美学和功能作用相结合。游离骨瓣与即刻骨整合种植体的一期重建正在成为治疗下颌骨缺损的标准，并且在上颌重建中也具有类似的潜力。一名女性上颌尤文氏肉瘤在9岁时成功接受了新辅助化疗，右半上颌切除和闭孔假体重建，并提出了最终重建，抱怨闭孔不适合和鼻音亢进。她的重建由一个多学科的团队进行计算机模拟，包括左半边lefort I推进和右上颌重建与即刻骨整合种植体和义齿游离腓骨瓣。全牙修复，面中突出和口瘘矫正在一个手术阶段实现。本病例展示了一种成功的上颌重建方法，采用计算机计划的正颌手术结合游离腓骨重建和即刻骨整合种植体与义齿。
Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. A woman with maxillary Ewing’s sarcoma successfully treated at age nine with neoadjuvant chemotherapy, right hemi-maxillectomy and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit and hypernasality. Her reconstruction was computer-simulated by a multi-disciplinary team, consisting of left hemi-Lefort I advancement and right maxillary reconstruction with a free fibula flap with immediate osseointegrated implants and dental prosthesis. Full dental restoration, midface projection and oral fistula corrections were achieved in one operative stage using this approach. This case demonstrates a successful approach for maxillary reconstruction using computer-planned orthognathic surgery with free fibula reconstruction and immediate osseointegrated implants with dental prosthesis.