MANDIBULAR RECONSTRUCTION USING DISTRACTION OSTEOGENESIS

DOI 1 Citations 12 References
  • MITSUGI Masaharu
    Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital
  • TAKENOBU Toshihiko
    Department of Oral and Maxillofacial Surgery, Kobe City General Hospital

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Other Title
  • 顎骨延長を用いた下顎骨再建

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Abstract

With recent developments in plastic and reconstructive surgery, reconstruction of a relatively large defect in the mandible after oral tumor excision has become feasible by the transplantation of vascularized complex tissues containing bone, muscles, and skin; however, transplantation for large defects requires significant invasion and morbidity of the donor site, usually resulting in severe oral dysfunction. The concept of distraction osteogenesis was established in the 1950s by the Russian orthopedist, G.A. Ilizarov. After corticotomy of the long bone in the lower limb and rigid fixation with external device, a callus develops between bone segments by gradual traction of the distraction gap, and the newly formed callus matures to bone by fixation after the completion of lengthening. Ilizarov also developed the bone transport method for new bone formation of intermediate defective regions caused by injury, tumor excision, or other acquired disorders. In this method, the transport segment is prepared by osteotomising the disk of the healthy long bone adjacent to the defective region, and slowly moving to the other healthy stump produces new bone and surrounding tissues. The new bone is regenerated within the regions through which the transport segment has passed, resulting in tissue regeneration in the intermediate defective region. There is also a bifocal distraction method, in which a transport segment is produced and moved through the entire defective region, and a trifocal distraction method, in which transport segments are produced at both ends of the defect region, and moved in opposite directions. In summary, we performed distraction osteogenesis using a combination of the bone transport method and transplantation of a small volume of bone, and achieved reconstruction of mandibular defects. The treatment period is long, but functionally and morphologically good results are obtained without significant invasion of other regions, suggesting that our methods could be used as an effective reconstruction method in the future.

Journal

  • Toukeibu Gan

    Toukeibu Gan 32 (4), 404-409, 2006

    Japan Society for Head and Neck Cancer

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