前頭蓋底の再建術式の標準化と外傷への応用

Size: px

Start display at page:

Download "前頭蓋底の再建術式の標準化と外傷への応用"

あいりだいほうじ
5 years ago
Views:

1 watertight watertight 53 5 temporal musculo pericranial flap frontal musculo pericranial flap

2 / A B C 2 loose areolar tissue A BC 10cm 10 12cm 1 loose areolar tissue

3 52 4 a b supraorbital bar supraorbital bar watertight 8 2/3 loose areolar tissue 5 loose areolar tissue loose areolar tissue 2 temporal line 2cm loose areolar tissue net work

52 4 7 6 5 9 2cm loose areolar tissue 3.

pericranial flap 10 11 80 7 12 pericranial flap 7

4 cm loose areolar tissue 3. pericranium 10 loose areolar tissue flap pericranium pericranial flap pericranial flap 7 pericranium watertight watertight 2/3 2 2cm cm

5 52 4 a b 8 9 ABC supraorbital bar D EF watertight 7 spinal drainage 2. 2/3 overlap flap 2/3 6 supraorbital bar 9supraorbital bar pedicle supraorbital bar overlap

6 A B C 9 3. supraorbital bar 9 supraorbital bar pedicle bed up 20 bed up 1 watertight flap

7 52 4 a b c d e f 11 a b 3D CTc CT d 3D CTe CT f watertight le Fort I 11a b c

8 d e f watertight Kiyokawa K, Tai Y, Yanaga H, Inoue Y, Hayakawa K, et al A surgical method for treating anterior skull base injuries. Cranio Maxillofacial Surg , Kiyokawa K, Tai Y, Inoue Y, Tanabe HY, Hayakawa K, et al Efficacy of temporal musculopericranial flap for reconstruction of the anterior base of skull. Scand J Plast Reconstr Hand Surg , Kiyokawa K, Tai Y, Inoue Y, Yanaga H, Mori K, et al A reconstruction method using musculo pericranial flaps that prevents cerebrospinal fluid rhinorrhea and intracranial complications after extended anterior skull base. Skull Base Surg , Nakajima H, Imanishi N, Minabe T The arterial anatomy of the temporal region and the vascular basis of various temporal flap. Br J Plast Surg , Argenta LC, Friedman RJ, Dingman RO, Duus EC The versatility of pericranial flaps. Plast Reconstr Surg , Price JC, Loury M, Carson B Johns ME The pericranial flap for reconstruction of anterior skull base defects. Laryngoscope , Jackson IT, Adham MN, Marsh WR Use of the Galeal frontalis myofascial flap in craniofacial surgery. Plast Reconstr Surg , Fukuta K, Potparic Z, Sugihara T, Rachmiel A, Forté RA, et al A cadaver investigation of the blood supply of the galeal frontalis flap. Plast Reconstr Surg , Brisman R, Hughes JEO, Mount LA Cerebrospinal fluid rhinorrhoea. Arch Neurol , Summary STANDARDIZATION OF THE METHODS OF THE RECONSTRUCTION OF THE ANTERIOR SKULL BASE AND THE APPLICATION TO THE SKULL BASE INJURY Hideaki Rikimaru, PhD, MD Kensuke Kiyokawa, PhD, MD Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine In reconstruction of the anterior skull base, it is important to repair the dural defect to be a watertight, and to surely intercept between the cranial cavity and the nasal or para nasal cavity. The temporal musculo pericranial flap that is the local flap with the blood circulation is the most useful reconstructive material for the dural defect. In the interception between the cranial cavity and the nasal or para nasal cavity, the frontal musculo pericranial flap is used. The reconstructive methodbecamesafebyusingtheseflaps. Therefore,it

9 52 4 was standardized and adapted to the skull base injury in our institution. We performed this reconstructive method on 53 cases after the resection of the tumor of the anterior skull base and the skull base injury. The local infection was developed in 5 cases and they were all healed by debridement and irrigation. None of the patients developed severe complication including liquorrhea, meningitis, or brain abscess. This method using these local flap was very safe and effective. Key words reconstruction of the skullbase, temporal musculo pericranial flap, frontal musculo pericranial flap

Study on Deformation of Fixation Devices of RED System in Maxillary Distraction Osteogenesis KoUJI OHTA, HIDETOSHI TOHMORI, MASARU SUGIYAMA, TAKESHI N

Study on Deformation of Fixation Devices of RED System in Maxillary Distraction Osteogenesis KoUJI OHTA, HIDETOSHI TOHMORI, MASARU SUGIYAMA, TAKESHI NOBUMORI, SHINGO INOUE, KOTARO TANIMOTO*, KAZUO TANNE