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Craniofacial Reconstruction (craniofacial + reconstruction)

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Medical Sciences100%

Selected Abstracts

Omental free flap reconstruction in complex head and neck deformities,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2002
Albert Losken MD
Abstract Background Microvascular free flaps continue to revolutionize coverage options in head and neck reconstruction. This article reviews our 25-year experience with omental free tissue transfers. Methods All patients who underwent free omental transfer to the head and neck region were reviewed. Results Fifty-five patients were included with omental transfers to the scalp (25%), craniofacial (62%), and neck (13%) region. Indications were tumor resections, burn wound, hemifacial atrophy, trauma, and moyamoya disease. Average follow-up was 3.1 years (range, 2 months,13 years). Donor site morbidities included abdominal wound infection, gastric outlet obstruction, and postoperative bleeding. Recipient site morbidities included partial flap loss in four patients (7%) total flap loss in two patients (3.6%), and three hematomas. Conclusions The omental free flap has acceptable abdominal morbidity and provides sufficient soft tissue coverage with a 96.4% survival. The thickness \and versatility of omentum provide sufficient contour molding for craniofacial reconstruction. It is an attractive alternative for reconstruction of large scalp defects and badly irradiated tissue. © 2002 Wiley Periodicals, Inc. Head Neck 24: 326,331, 2002; DOI 10.1002/hed.10082 [source]

Design and assessment of a tissue-engineered model of human phalanges and a small joint

ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 4 2005
WJ Landis
Structured Abstract Authors ,, Landis WJ, Jacquet R, Hillyer J, Lowder E, Yanke A, Siperko L, Asamura S, Kusuhara H, Enjo M, Chubinskaya S, Potter K, Isogai N. Objectives ,, To develop models of human phalanges and small joints by suturing different cell-polymer constructs that are then implanted in athymic (nude) mice. Design ,, Models consisted of bovine periosteum, cartilage, and/or tendon cells seeded onto biodegradable polymer scaffolds of either polyglycolic acid (PGA) or copolymers of PGA and poly-L-lactic acid (PLLA) or poly- , -caprolactone (PCL) and PLLA. Constructs were fabricated to produce a distal phalanx, middle phalanx, or distal interphalangeal joint. Setting and Sample Population ,, Studies of more than 250 harvested implants were conducted at the Northeastern Ohio Universities College of Medicine. Experimental Variable ,, Polymer scaffold, cell type, and implantation time were examined. Outcome Measure ,, Tissue-engineered specimens were characterized by histology, transmission electron microscopy, in situ hybridization, laser capture microdissection and qualitative and quantitative polymerase chain reaction analysis, magnetic resonance microscopy, and X-ray microtomography. Results ,, Over periods to 60 weeks of implantation, constructs developed through vascularity from host mice; formed new cartilage, bone, and/or tendon; expressed characteristic genes of bovine origin, including type I, II and X collagen, osteopontin, aggrecan, biglycan, and bone sialoprotein; secreted corresponding proteins; responded to applied mechanical stimuli; and maintained shapes of human phalanges with small joints. Conclusion ,, Results give insight into construct processes of tissue regeneration and development and suggest more complete tissue-engineered cartilage, bone, and tendon models. These should have significant future scientific and clinical applications in medicine, including their use in plastic surgery, orthopaedics, craniofacial reconstruction, and teratology. [source]

The Acetabular Reamer: A Unique Tool for Anterior Iliac Crest Bone Graft Harvesting

THE LARYNGOSCOPE, Issue 3 2005
David G. Gossman MD
Abstract Bone grafting is often required in craniofacial reconstruction. Morselized corticocancellous bone grafts are particularly useful in applications such as filling and contouring irregular bony defects. Obtaining grafts of this consistency by traditional methods is difficult. An efficient harvesting method that can produce such grafting material in clinically useful quantities is needed. We report the use of a mechanical acetabular reamer for the purpose of harvesting a bone graft from the iliac crest. [source]

HN09P ASSESSMENT OF FREE FIBULAR BONE IN THE RECONSTRUCTED MANDIBLE USING THREE-DIMENSIONAL COMPUTER GENERATED IMAGES

ANZ JOURNAL OF SURGERY, Issue 2007
H. Nabi
We report the preliminary results of the Royal Adelaide Hospital experience with multidimensional simulated views of the fibula-flap reconstructed mandible. The free fibular flap is a well recognised option for mandibular reconstruction. What is not well understood however is how the fibula behaves in comparison to the dentate mandible. To date, skeletal remodelling and bone atrophy has only been assessed using standard orthopantogram films. For many years three-dimensional (3D) computer generated models using data from CT scans have been utilised for craniofacial reconstruction. We proposed that these images will enable us to more accurately visualise the integration of the transplanted graft within the mandible. We recalled and CT scanned patients from 2004 to 2006 that underwent free fibular flaps for reconstruction of mandibular malignancy and performed 3D reconstruction of these images. This is the first reported series of multidimensional computer generated images to assess bone in the reconstructed mandible. [source]