First Experiences with Simultaneous Skeletal and Soft Tissue Reconstruction of Noma-Related Facial Defects
| Autor: | C. Peter Cornelius, Goetz A. Giessler, Paul K. Lim, André Borsche, Andreas B. Schmidt |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Chronic exposure Microsurgery medicine.medical_specialty Adolescent Noma Ribs Anastomosis Surgical Flaps Soft tissue reconstruction Ankylosis Humans Medicine Femur Child business.industry Anastomosis Surgical Infant Soft tissue Plastic Surgery Procedures medicine.disease Temporomandibular joint Surgery Treatment Outcome medicine.anatomical_structure Fibula Female Osteitis business |
| Zdroj: | Journal of Reconstructive Microsurgery. 28:085-094 |
| ISSN: | 1098-8947 0743-684X |
| Popis: | Noma victims suffer from a three-dimensional facial soft-tissue loss. Some may also develop complex viscerocranial defects, due to acute osteitis, chronic exposure, or arrested skeletal growth. Reconstruction has mainly focused on soft tissue so far, whereas skeletal restoration was mostly avoided. After successful microvascular soft tissue free flap reconstruction, we now included skeletal restoration and mandibular ankylosis release into the initial step of complex noma surgery. One free rib graft and parascapular flap, one microvascular osteomyocutaneous flap from the subscapular system, and two sequential chimeric free flaps including vascularized bone were used as the initial steps for facial reconstruction. Ankylosis release could spare the temporomandibular joint. Complex noma reconstruction should include skeletal restoration. Avascular bone is acceptable in cases with complete vascularized graft coverage. Microsurgical chimeric flaps are preferable as they can reduce the number and complexity of secondary operations and provide viable, infection-resistant bone supporting facial growth. |
| Databáze: | OpenAIRE |
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