Condyle Reconstruction with Autogenous Lliac Particulate Marrow and Cancellous Bone after Segmental Resection of a Mandibular Ameloblastoma from an Intraoral Approach: A Case Report

以口內法施行區段截骨術切除下顎骨造釉細胞瘤同時以自體腸骨髓質骨碎片重建下顎髁突：病例報告

陳靜容(Ching-Jung Chen) ； 賴聖宗(Steven Lai)

《中華民國口腔顎面外科學會雜誌》 8卷1期 (1997/03) Pp. 35-44

https://doi.org/10.7104/CJOMS.199703.0035

摘要

傳統的顳顎關節重建手術通常以異質移植體或取自病人之自體骨移植來完成。使用赝復關節常造成的後遺症包括急性感染或慢性炎性反應導致關節功能因纖維組織逐漸增生而使活動範圍慢慢變小。而使用肋軟骨移植骨片，是目前最多人採用，也是最理想的辦法，但是因為一般需要重建髁頭的病例，都伴有其他部份的缺損，因而需要再拿其他地方的骨頭或併用赝復物。本病例是報告一個男性成年人因造釉細胞瘤切除左側下顎髁突，下顎枝以及部份下顎骨體，同時以自體腸骨髓質骨碎片來重建缺損區。術後七個月追蹤檢查發現，臉部變形量很少，下顎骨功能一切正常，最大開口度達45 mm，但下顎骨在最大開口時會微偏左邊。以腸骨髓質骨碎片重建整個髁突為一新的嘗試，我們會做長期追蹤。

關鍵字

髁突重建 ； 髓質骨碎片移植

並列摘要

Reconstruction of the temporomandibular joint has generally been accomplished in the past with alloplastic materials or with tissues harvested from the patient. The long-term function of prosthetic joints has been subjected to complications such as acute infection and chronic inflammatory problems as a result of access of wear particles to the immunologic system and a limited joint function. With costochondral graft, now the most common and maybe the best way to reconstruct the TMJ, but there is still a major drawback which is a lack of bulk and it needs a second donor site or another implant material in larger bone defects. Here we present a case of a large ameloblastoma of the left mandible. After wide excision, the condyle process, whole ramus, angle and half of the body were all excised through an intraoral approach, then reconstructed at the same time by using particulate marrow and cancellous bone of the ilium. Surgical intervention was performed without complications. Even though there was a mild degree of mandibular deviation to the affected side during wide mouth opening, the facial appearance and mandibular functions were all excellent on the last visit five months after the operation. The advantages of providing satisfactory mandibular functions and eliminating multiple donor sites morbidity recommend the use of particulate marrow and cancellous bone to restore a whole missing condyle. We will continue to follow up this case.

並列關鍵字

condyle reconstruction ； particulate marrow and cancellous bone