광범위 종양절제술 후 발생한 하악 결손의 재건

• 영문명: Reconstruction of Mandible Defect after Tumor Ablation Surgery : Versatility of Fibular Free Flap Design
• 발행기관: 대한두경부종양학회
• 저자명: 설철환(Chul Hwan Seul) 이영대(Young Dae Lee) 탁관철(Kwan Chui Tark) 유대현(Dae Hyun Lew)
• 간행물 정보: 『대한두경부종양학회지』제21권 제2호, 190~195쪽, 전체 6쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2005.11.30

영문 초록

Background and Objectives: Fibula is the flap of choice for reconstruction of wide mandible defects after tumor ablation surgery. In mandible reconstruction, restoring the mandible frame to provide mandibular contour and dental arch while restoring masticatory function are important. Even though vascularized fibula can be osteotomized freely, proper design and flap insetting is not easy because of its three dimensional structure and difference in design according to the defect sites. We reviewed patients who underwent mandible reconstruction with fibular flaps according to the defect sites and suggest proper modification methods of fibular flap according to the various defects sites after tumor ablation surgery. Materials and Methods: Twelve consecutive mandible reconstruction with fibular free flaps were performed for defects after tumor ablation surgery. Patients were classified into 4 groups according to the type of mandibular defect(Group 1 : defect on central segment including symphysis, Group 2 : defect on lateral segment(with or without central segment) confined to body, Group 3 : defect on body and ascending ramus that does not include the condyle, Group 4 : defect including the condyle). Results: We suggest different modification methods of fibular free flap for each patient group. Group 1, 3 ; contour by using multiple closing wedge osteotomy. Group 2 ; single or double barrel reconstruction without wedge osteotomy. Group 4 ; contour using single or multiple wedge osteotomy and condylar reconstruction with costochondral graft. Conclusion: Fibular free flaps can be contoured to any desired shape after multiple osteotomies to restore various mandibular defects. It is a reliable and versatile method for reconstruction of mandibular defects after tumor ablation surgery.

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키워드

하악 재건 비골 유리 피판 Mandible reconstruction Fibular free flap Versatility of fibular flap design