Jaw Reconstruction with Vascularized Cranial Bone

  • Scott L. Spear
  • Alfred J. Luessenhop
  • Ayman Hakki
Conference paper

Abstract

The total rehabilitation of the patient with loss of the mandible remains one of the most difficult reconstructive problems. This is especially true where the bony loss is massive and there are unfavorable local soft tissue circumstances resulting from either radiation or scarring. The ideal solution would allow reconstitution of the entire mandible, providing osseous union even in a scarred tissue bed. Having created a semblance of normal mandibular anatomy, it would allow for rehabilitation of speech, swallowing, and mastication. Ideally, the surgical procedure would have a low rate of failure and would result in minimal donor site deformity. Alloplastic implants, homologous bone grafts, and autologous bone grafts have limited application in these cases. Microvascular free tissue transfers of bone and soft tissue have broadened the horizons of reconstruction, but these techniques are limited primarily to unilateral or modest bilateral problems, and substantial donor site deformity is associated with many of them. There is also significant risk of failure with microvascular techniques, especially when the recipient site is affected by previous radiation or scarring.

Keywords

Bicoronal 

References

  1. 1.
    Conley J (1972) Use of composite flaps containing bone for major repairs in the head and neck. Plast Reconstr Surg 49: 522PubMedCrossRefGoogle Scholar
  2. 2.
    Conley J, Cinelli PB, Johnson P, Koss M (1973) Investigation of bone changes in composite flaps after transfer to the head and neck region. Plast Reconstr Surg 51:658PubMedCrossRefGoogle Scholar
  3. 3.
    Daniel RK (1978) Mandibular reconstruction with free-tissue transfers. Ann Plast Surg 1: 346PubMedCrossRefGoogle Scholar
  4. 4.
    Donski PK, Carwell GR, Sharzer LA (1979) Growth in revascularized bone grafts in young puppies. Plast Reconstr Surg 64: 239PubMedCrossRefGoogle Scholar
  5. 5.
    Panje W, Cutting C (1980) Trapezius osteomyocutaneous island flap for reconstruction of the anterior floor of the mouth and mandible. Head Neck Surg 3: 66PubMedCrossRefGoogle Scholar
  6. 6.
    Puckett CL, Hurwitz JS, Metzler MH, Silver D (1979) Bone formation by revascularized periosteal and bone grafts compared with traditional bone grafts. Plast Reconstr Surg 64: 361PubMedCrossRefGoogle Scholar
  7. 7.
    Snyder CC, Bateman JM, Davis CW, et al (1970) Mandibulofacial restoration with live osteocutaneous flaps. Plast Reconstr Surg 45:14PubMedCrossRefGoogle Scholar
  8. 8.
    Taylor GI, Townsend P, Corlett R (1975) Superiority of the deep circumflex iliac vessels as the supply for free groin flaps: experimental work. Plast Reconstr Surg 64: 595CrossRefGoogle Scholar
  9. 9.
    Taylor GI, Townsend P, Corlett R (1979) Superiority of the deep circumflex iliac vessels as the supply for free groin flaps: clinical work. Plast Reconstr Surg 64:745PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • Scott L. Spear
  • Alfred J. Luessenhop
  • Ayman Hakki
    • 1
  1. 1.WashingtonUSA

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