Facial bone reconstruction with prefabricated vascularized calvarium flaps in children and young adults: Advantages and long-term results

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• 作者：Eva Meia Rü ; egg ; ^{Eva.Ruegg@hcuge.ch} ; Paul Gniadek¹ ; Ali Modarressi ; Denise Baratti-Mayer ; Brigitte Pittet-Cu&eacute ; nod
• 关键词：Calvarium flap ; Noma ; Face reconstruction ; Bone reconstruction ; Bone flap ; Reconstruction children
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：44
• 期：12
• 页码：1880-1888
• 全文大小：2820 K
• 卷排序：44

文摘

Reconstruction of facial bone defects in children is challenging. The use of well-vascularized bone is mandatory to obtain stable lasting results. This study reports our experience of facial bone reconstruction using prefabricated vascularized calvarium flaps.MethodsRetrospective case series of 50 patients who underwent 52 maxillary, malar, and mandibular reconstructions between 1988 and 2014 using prefabricated vascularized calvarium flaps. Forty-nine patients suffered from noma sequels; one patient had craniofacial cleft Tessier 3–11. Surgery consisted of a two-step procedure beginning with flap delay and prelamination with skin grafting on the galea. Flap harvest followed at least 2 weeks later (range, 2–16 weeks), including a full-thickness calvarium fragment, which was set into the facial defect.ResultsEarly complications concerned wound healing and infections requiring surgical revision in six patients at the recipient and six at the donor site. There was one flap loss. Clinical long-term assessment at 15-year median follow-up (range, 1–27 years) showed good results, assuring facial height and contour. Radiological long-term results demonstrated excellent integration of the flap to the adjacent facial skeleton of the growing child.ConclusionsPrefabricated vascularized calvarium flaps are an effective, safe and lasting method for reconstruction of facial bone defects in children.