Vascularized Calvarial Bone Flaps and Midface Reconstruction
After studying this article, the participant should be able to: 1. Identify the fascial layers of the temporalis region. 2. Understand the three-dimensional nature of the orbit and upper maxillectomy defects. 3. Understand the surgical harvest of temporalis flaps and temporoparietal flaps with vascu...
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Veröffentlicht in: | Plastic and reconstructive surgery (1963) 2008-07, Vol.122 (1), p.10e-18e |
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creator | Davison, Steven P. Mesbahi, Ali N. Clemens, Mark W. Picken, Catherine A. |
description | After studying this article, the participant should be able to: 1. Identify the fascial layers of the temporalis region. 2. Understand the three-dimensional nature of the orbit and upper maxillectomy defects. 3. Understand the surgical harvest of temporalis flaps and temporoparietal flaps with vascularized bone. 4. Appreciate preoperative risk factors and postoperative complications.
Although vascularized calvarial bone grafts were originally explored for use in reconstruction of midface hypoplasia defects, they offer significant value in application to oncologic reconstruction of the midface.
A review of eight cases of midface reconstruction using vascularized calvarial grafts was performed to illustrate the versatility and dependability of these flaps.
Adequate bony and soft-tissue contours were achieved with no clinical evidence of bone graft resorption. No immediate postoperative complications including infection and hematoma or seroma formation were noted. One patient experienced a delayed sinusitis from a blocked duct.
The use of vascularized calvarial grafts supported by temporoparietal fascia, combined deep temporal fascia, and temporalis muscle provides excellent soft-tissue coverage and adequate bone stock for reconstruction of complex defects. Maintaining vascularization of the bone graft not only resists infection but also opposes resorption associated with nonvascularized grafts, particularly those in compromised wounds. |
doi_str_mv | 10.1097/PRS.0b013e3181774115 |
format | Article |
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Although vascularized calvarial bone grafts were originally explored for use in reconstruction of midface hypoplasia defects, they offer significant value in application to oncologic reconstruction of the midface.
A review of eight cases of midface reconstruction using vascularized calvarial grafts was performed to illustrate the versatility and dependability of these flaps.
Adequate bony and soft-tissue contours were achieved with no clinical evidence of bone graft resorption. No immediate postoperative complications including infection and hematoma or seroma formation were noted. One patient experienced a delayed sinusitis from a blocked duct.
The use of vascularized calvarial grafts supported by temporoparietal fascia, combined deep temporal fascia, and temporalis muscle provides excellent soft-tissue coverage and adequate bone stock for reconstruction of complex defects. Maintaining vascularization of the bone graft not only resists infection but also opposes resorption associated with nonvascularized grafts, particularly those in compromised wounds.</description><identifier>ISSN: 0032-1052</identifier><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/PRS.0b013e3181774115</identifier><identifier>PMID: 18594355</identifier><language>eng</language><publisher>United States: American Society of Plastic Surgeons</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Face - surgery ; Female ; Head - anatomy & histology ; Head and Neck Neoplasms - surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skull - blood supply ; Surgical Flaps - blood supply ; Wounds and Injuries - etiology ; Wounds and Injuries - surgery ; Wounds, Gunshot - surgery</subject><ispartof>Plastic and reconstructive surgery (1963), 2008-07, Vol.122 (1), p.10e-18e</ispartof><rights>American Society of Plastic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3500-1be0433c3405526c69fa2f618ed1a9525ab96fe9a64b11f1f6a539be9dd2f13d3</citedby><cites>FETCH-LOGICAL-c3500-1be0433c3405526c69fa2f618ed1a9525ab96fe9a64b11f1f6a539be9dd2f13d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18594355$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Davison, Steven P.</creatorcontrib><creatorcontrib>Mesbahi, Ali N.</creatorcontrib><creatorcontrib>Clemens, Mark W.</creatorcontrib><creatorcontrib>Picken, Catherine A.</creatorcontrib><title>Vascularized Calvarial Bone Flaps and Midface Reconstruction</title><title>Plastic and reconstructive surgery (1963)</title><addtitle>Plast Reconstr Surg</addtitle><description>After studying this article, the participant should be able to: 1. Identify the fascial layers of the temporalis region. 2. Understand the three-dimensional nature of the orbit and upper maxillectomy defects. 3. Understand the surgical harvest of temporalis flaps and temporoparietal flaps with vascularized bone. 4. Appreciate preoperative risk factors and postoperative complications.
Although vascularized calvarial bone grafts were originally explored for use in reconstruction of midface hypoplasia defects, they offer significant value in application to oncologic reconstruction of the midface.
A review of eight cases of midface reconstruction using vascularized calvarial grafts was performed to illustrate the versatility and dependability of these flaps.
Adequate bony and soft-tissue contours were achieved with no clinical evidence of bone graft resorption. No immediate postoperative complications including infection and hematoma or seroma formation were noted. One patient experienced a delayed sinusitis from a blocked duct.
The use of vascularized calvarial grafts supported by temporoparietal fascia, combined deep temporal fascia, and temporalis muscle provides excellent soft-tissue coverage and adequate bone stock for reconstruction of complex defects. Maintaining vascularization of the bone graft not only resists infection but also opposes resorption associated with nonvascularized grafts, particularly those in compromised wounds.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Face - surgery</subject><subject>Female</subject><subject>Head - anatomy & histology</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Reconstructive Surgical Procedures</subject><subject>Skull - blood supply</subject><subject>Surgical Flaps - blood supply</subject><subject>Wounds and Injuries - etiology</subject><subject>Wounds and Injuries - surgery</subject><subject>Wounds, Gunshot - surgery</subject><issn>0032-1052</issn><issn>1529-4242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkF9L3UAQxZei1KvtNyiSJ9-iM_svWfBFL7UKinJt-7psNrOYdm9y3U16aT99I14QHBhmBs45Az_GviCcIpjq7GH1eAoNoCCBNVaVRFQf2AIVN6Xkku-xBYDgJYLiB-ww518AWAmtPrIDrJWRQqkFO__psp-iS90_aouli3_m1cXicuipuIpukwvXt8Vd1wbnqViRH_o8psmP3dB_YvvBxUyfd_OI_bj6-n15Xd7ef7tZXtyWXiiAEhsCKYQXEpTi2msTHA8aa2rRGcWVa4wOZJyWDWLAoJ0SpiHTtjygaMURO3nN3aTheaI82nWXPcXoehqmbLXh9fxBzkL5KvRpyDlRsJvUrV36axHsCzU7U7Pvqc22413-1KypfTPtML3lboc4Usq_47SlZJ_IxfHJwlxaCVlygBqq-SrnliD-Azlrd4Q</recordid><startdate>20080701</startdate><enddate>20080701</enddate><creator>Davison, Steven P.</creator><creator>Mesbahi, Ali N.</creator><creator>Clemens, Mark W.</creator><creator>Picken, Catherine A.</creator><general>American Society of Plastic Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080701</creationdate><title>Vascularized Calvarial Bone Flaps and Midface Reconstruction</title><author>Davison, Steven P. ; Mesbahi, Ali N. ; Clemens, Mark W. ; Picken, Catherine A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3500-1be0433c3405526c69fa2f618ed1a9525ab96fe9a64b11f1f6a539be9dd2f13d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Face - surgery</topic><topic>Female</topic><topic>Head - anatomy & histology</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Reconstructive Surgical Procedures</topic><topic>Skull - blood supply</topic><topic>Surgical Flaps - blood supply</topic><topic>Wounds and Injuries - etiology</topic><topic>Wounds and Injuries - surgery</topic><topic>Wounds, Gunshot - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Davison, Steven P.</creatorcontrib><creatorcontrib>Mesbahi, Ali N.</creatorcontrib><creatorcontrib>Clemens, Mark W.</creatorcontrib><creatorcontrib>Picken, Catherine A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Plastic and reconstructive surgery (1963)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Davison, Steven P.</au><au>Mesbahi, Ali N.</au><au>Clemens, Mark W.</au><au>Picken, Catherine A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascularized Calvarial Bone Flaps and Midface Reconstruction</atitle><jtitle>Plastic and reconstructive surgery (1963)</jtitle><addtitle>Plast Reconstr Surg</addtitle><date>2008-07-01</date><risdate>2008</risdate><volume>122</volume><issue>1</issue><spage>10e</spage><epage>18e</epage><pages>10e-18e</pages><issn>0032-1052</issn><eissn>1529-4242</eissn><abstract>After studying this article, the participant should be able to: 1. Identify the fascial layers of the temporalis region. 2. Understand the three-dimensional nature of the orbit and upper maxillectomy defects. 3. Understand the surgical harvest of temporalis flaps and temporoparietal flaps with vascularized bone. 4. Appreciate preoperative risk factors and postoperative complications.
Although vascularized calvarial bone grafts were originally explored for use in reconstruction of midface hypoplasia defects, they offer significant value in application to oncologic reconstruction of the midface.
A review of eight cases of midface reconstruction using vascularized calvarial grafts was performed to illustrate the versatility and dependability of these flaps.
Adequate bony and soft-tissue contours were achieved with no clinical evidence of bone graft resorption. No immediate postoperative complications including infection and hematoma or seroma formation were noted. One patient experienced a delayed sinusitis from a blocked duct.
The use of vascularized calvarial grafts supported by temporoparietal fascia, combined deep temporal fascia, and temporalis muscle provides excellent soft-tissue coverage and adequate bone stock for reconstruction of complex defects. Maintaining vascularization of the bone graft not only resists infection but also opposes resorption associated with nonvascularized grafts, particularly those in compromised wounds.</abstract><cop>United States</cop><pub>American Society of Plastic Surgeons</pub><pmid>18594355</pmid><doi>10.1097/PRS.0b013e3181774115</doi></addata></record> |
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source | MEDLINE; Journals@Ovid Complete |
subjects | Adult Aged Aged, 80 and over Face - surgery Female Head - anatomy & histology Head and Neck Neoplasms - surgery Humans Male Middle Aged Reconstructive Surgical Procedures Skull - blood supply Surgical Flaps - blood supply Wounds and Injuries - etiology Wounds and Injuries - surgery Wounds, Gunshot - surgery |
title | Vascularized Calvarial Bone Flaps and Midface Reconstruction |
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