A generalizable procedure for Brown's class Ⅱ and Ⅲ defects reconstruction with deep circumflex iliac artery flap using computer-assisted technique.

Autor: Dou CB; Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, China; Dongfeng Stomatological Hospital, Hubei University of Medicine, 442000, Shiyan, China., Gao XP; Dongfeng Stomatological Hospital, Hubei University of Medicine, 442000, Shiyan, China., Yu ZL; Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, China; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, China. Electronic address: zili09@whu.edu.cn., Jia J; Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 430079, Wuhan, China; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 430079, Wuhan, China. Electronic address: junjia@whu.edu.cn.
Jazyk: angličtina
Zdroj: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2024 Nov 02. Date of Electronic Publication: 2024 Nov 02.
DOI: 10.1016/j.jcms.2024.10.009
Abstrakt: Objective: This study summarizes and analyzes the characteristics of deep circumflex iliac artery (DCIA) flap reconstruction for maxillary defects and proposes a generalized protocol under the guidance of computer-assisted technique to enhance surgical efficiency and success rate.
Materials and Methods: We retrospectively reviewed 10 cases of maxillary defects reconstructed using DCIA flaps under the application of computer-assisted technique, collecting clinical data for statistical analysis.
Results: These cases included 2 cystic lesions, 2 mucinous tumors, 2 ameloblastomas, 1 mucoepidermoid carcinoma, 1 odontogenic fibroma, 1 bone defect following squamous cell carcinoma (SCC) surgery, and 1 ossifying fibroma. According to Brown's classification system, there were 7 Type IIb defects, 1 Type IId defect, 1 Type IIIb defect, and 1 Type IIId defect. The length of the iliac bone harvested ranged from 42 mm to 100 mm, and the width from 20 mm to 51 mm. In 7 patients, chimeric iliac myofascial flaps were used; in 2 patients, deep circumflex iliac artery perforator (DCIAP) flaps were utilized; and in 1 patient, a vascularized iliac crest was employed. The recipient vessels were the facial artery and vein in all cases. Intraoral anastomoses were performed in 4 cases, and submandibular anastomoses in 6 cases. The donor site was chosen from the ipsilateral ilium in 8 patients and from the contralateral ilium in 2 patients. The mean operative time was 8.74 hours. Postoperatively, 9 patients recovered well without any complications, while 1 patient experienced necrosis of the bone flap on the first day after surgery and underwent secondary reconstruction using a vascularized fibula flap. The average postoperative hospital stay was 8.6 days.
Conclusion: The combination of DCIA flaps with computer-assisted technique provides a reliable method for the reconstruction of maxillary defects and functional restoration. Establishing generalized procedures could facilitate its broader application.
Competing Interests: Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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