One-Stage Repair and Reconstruction of Craniomaxillofacial Bone Defects

Jianhua Wang, Chao Hu, Gang Zhang, Songbo Qiu, Jun Cai, Xiaobo Wu, Zhao Xiang, Yinghui Tan

Department of Oral & Maxillofacial Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.

DOI: 10.4236/mps.2013.31002                

Abstract

Objective: Severe craniomaxillofacial injuries and craniomaxillofacial tumors can lead to craniomaxillofacial bone defects and deformities. Seriously affect the patients’ appearance and quality of life. So one-stage repair and reconstruction of craniomaxillofacial bone defects is of great significance. The current study summarizes the clinical experience of one-stage repair and reconstruction of craniomaxillofacial bone defects. Material and Methods: Data in one-stage repair and reconstruction of craniomaxillofacial bone defects performed on 13 patients were retrospectively analyzed out of 34 patients with craniomaxillofacial injuries or tumors who received treatment at the outpatient department between January 2002 and March 2011. Surgical indications and approaches were explored after two typical cases were detected. Results: One-stage repair and reconstruction of bone defects was suitable for patients with craniomaxillofacial injuries and excised craniomaxillofacial benign tumors. Adjacent autogenous bones and artificial materials (such as titanium plates, titanium mesh, and so on) work well for the repair of the craniomaxillofacial bone frame and restoration of facial features. Conclusions: Surgical indications should be strictly selected in one-stage repair and reconstruction of craniomaxillofacial bone defects and deformities. Furthermore, the adoption of autogenous bones and artificial materials is a good choice in restoring the craniofacial features.

Keywords

Craniomaxillofacial; Bone Defects; Repair and Reconstruction

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	J. T. Goodrich, “Craniofacial Surgery: Complications and Their Prevention,” Seminars in Pediatric Neurology, Vol. 11, No. 4, 2008, pp. 288-300. doi:10.1016/j.spen.2004.10.001
[2]	E. Neovius and T. Engstrand, “Craniofacial Reconstruction with Bone and Biomaterials: Review over the Last 11 Years,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 63, No. 10, 2010, pp. 1615-1623. doi:10.1016/j.bjps.2009.06.003
[3]	D. Bondin and G. L. Ross, “The Use of a Combined Radial Forearm Flap and Radial Fascial Flap for Layered Dural Lining and an Orbital Defect Reconstruction,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 64, No. 7, 2011, pp. e167-e169.
[4]	F. P. Fechner and D. G. Deschler, “Microvascular Free Flap Reconstruction after Craniofacial Trauma,” Operative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 13, No. 4, 2002, pp. 309-315.
[5]	J. J. Kuttenberger and N. Hardt, “Long-Term Results Following Reconstruction of Craniofacial Defects with Titanium Micro-Mesh Systems,” Journal of Cranio-Maxillofacial Surgery, Vol. 29, No. 2, 2001, pp. 75-81. doi:10.1054/jcms.2001.0197
[6]	L. Pereira, M. A. Carron and R. H. Mathog, “Traditional Craniofacial Resection,” Operative Techniques in Otolaryngology—Head and Neck Surgery, Vol. 21, No. 1, 2010, pp. 2-8. doi:10.1016/j.otot.2009.06.004
[7]	U. Klammert, U. Gbureck and E. Vorndran, et al., “3D Powder Printed Calcium Phosphate Implants for Reconstruction of Cranial and Maxillofacial Defects,” Journal of Cranio-Maxillofacial Surgery, Vol. 38, No. 8, 2010, pp. 565-570. doi:10.1016/j.jcms.2010.01.009
[8]	F. J. Kramer, B. Sinikoviv and M. Mueller, et al., “Experimental Application of a Bifocal Transport Osteogenesis for Craniofacial Reconstruction,” Journal of Cranio-Maxillofacial Surgery, Vol. 36, No. 4, 2008, pp. 218-226. doi:10.1016/j.jcms.2007.12.001
[9]	D. Marchac and A. Greensmith, “Long-Term Experience with Methylmethacrylate Cranioplasty in Craniofacial Surgery,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 61, No. 7, 2008, pp. 744-752.
[10]	G. Cantù, C. L. Solero and N. Pizzi, et al., “Skull Base Reconstruction after Anterior Craniofacial Resection,” Journal of Cranio-Maxillofacial Surgery, Vol. 27, No. 4, 1999, pp. 228-234. doi:10.1016/S1010-5182(99)80034-1
[11]	C. S. Chang, L. Bergeron and C. C. Liao, et al., “Craniofacial Reconstruction of Primary Osteogenic Sacoma of the Skull,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 63, No. 8, 2010, pp. 1265-1268.
[12]	M. Lotfy, R. Xu and M. Mcgirt, et al., “Reconstruction of Skull Base Defects in Sphenoid Wing Dysplasia Associated with NeurofibromatosisⅠwith Titanium Mesh,” Clinical Neurology and Neurosurgery, Vol. 112, No. 10, 2010, pp. 909-914.
[13]	B. G. Bentz, M. H. Bilsky, J. P. Shah and D. Kraus, “Anterior Skull Base Surgery for Malignant Tumors: A Multivariate Analysis of 27 Years of Experience,” Head Neck, Vol. 25, No. 7, 2003, pp. 515-520. doi:10.1002/hed.10250
[14]	C. H. Buitrago-Téllez, W. Schilli and M. Bohnert, et al., “A Comprehensive Classification of Craniofacial Fractures: Postmortem and Clinical Studies with Two- and Three-Dimensional Computed Tomography,” Injury, Vol. 33, No. 8, 2002, pp. 651-668. doi:10.1016/S0020-1383(02)00119-5
[15]	J. J. Mendonca-Caridad, P. Juiz-Lopez and J. P. Rubio-Rodriguez, “Frontal Sinus Obliteration and Craniofacial Reconstruction with Platelet Rich Plasma in a Patient with Fibrous Dysplasia,” International Journal of Oral and Maxillofacial Surgery, Vol. 33, No. 1, 2006, pp. 88-91. doi:10.1016/j.ijom.2005.06.017
[16]	D. N. Silva, M. G. Oliveira and E. Meurer, et al., “Dimensional Error in Selective Laser Sintering and 3D-Printing of Models for Craniomaxillary Anatomy Reconstruction,” Journal of Cranio-Maxillofacial Surgery, Vol. 36, No. 8, 2008, pp. 443-449. doi:10.1016/j.jcms.2008.04.003
[17]	K. A. Matthew and M. J. Lawrence, “New Developments in Craniofacial Reconstruction,” Current Opinion in Otolaryngology & Head and Neck Surgery, Vol. 10, No. 4, 2002, pp. 282-285. doi:10.1097/00020840-200208000-00007
[18]	A. Müller, K. G. Krishnan and E. Uhl, et al., “The Application of Rapid Prototyping Techniques in Cranial Reconstruction and Preoperative Planning in Neurosurgery,” Journal of Craniofacial Surgery, Vol. 14, No. 6, 2003, pp. 899-914. doi:10.1097/00001665-200311000-00014
[19]	W. Tang, J. Long and F. Feng, et al., “Condyle Replacement after Tumor Resection: Comparison of Individual Prefabricated Titanium Implants and Costochondral Grafts,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, Vol. 108, No. 2, 2009, pp. 147-152. doi:10.1016/j.tripleo.2009.01.028
[20]	W. Tang, L. Guo and J. Long, et al., “Individual Design and Rapid Prototyping in Reconstruction of Orbital Wall Defects,” Journal of Oral and Maxillofacial Surgery, Vol. 68, No. 3, 2010, pp. 562-570. doi:10.1016/j.joms.2009.04.042
[21]	K. E. Salyer, C. R. Barcelo and Y. C. Por, “Extensive Neglected Psammomatoid Ossifying Fibroma with Craniofacial Deformity,” Journal of Craniofacial Surgery, Vol. 15, No. 6, 2004, pp. 1033-1039. doi:10.1097/00001665-200411000-00031