應用自體顱骨移植於顎顏面外傷合併大範圍骨缺損病人之重建

Using Calvarial Bone Graft for Large Bony Defect Reconstruction in Maxillofacial Trauma Patients

黃傳貴(Chuan-Kuei Huang) ； 雷文天(Man-Tien Lui) ； 高壽延(Shou-Yen Kao) ； 吳政憲(Cheng-Hsien Wu)

《臺灣口腔顎面外科學會雜誌》 20卷3期 (2009/09) Pp. 149-162

https://doi.org/10.7104/TJOMS.200909.0149

摘要

顎顏面區重建取自顱骨移植(calvarial bone graft)的歷史已將近有一個世紀。自1980年代學者Tessier開始大量以顱骨作爲顎顏面骨缺損重建，至今所累積的大量病例皆顯示顱骨移植比起其他的自體骨移植(autogenous bone grafts)有更佳的受骨區穩定性與較低的供骨區併發症。本篇病例報告將說明台北榮總口腔顎面外科利用自體顱骨移植，重建顎顏面區外傷合併大範圍骨缺損之經驗，並探討自體顱骨移植之適用性。結果發現自體顱骨移植的優點比起其他自體骨移植有較佳的受骨區穩定性與較低的供骨區併發症，且傷口隱藏在髮線後，並不影響病患的美觀。其缺點在於供骨區的骨厚度相對於其他供骨區域較薄，及可能在取骨時傷到底下的硬腦膜，但若配合超音波骨刀使用，將可降低手術的風險。對於顏面外傷合併大範圍骨缺損的病患，自體顱骨移植不啻爲一理想的選擇。

關鍵字

顱骨移植 ； 自體骨移植 ； 顎顏面外傷重建

並列摘要

The use of calvarial bone graft as a substitute for bony reconstruction in maxillofacial region had been reported about one century ago. In 1980, Tessier began to use calvarial bone grafts to correct maxillofacial defects and he had many successful cases until today. Compared to other autogenous bone grafts, calvarial bone grafts seem to have more recipient site stability and less donor site morbidity. In this report, we presented our experience in performing calvarial bone grafts for large bony defects in patients with maxillofacial trauma. The results display when compared to other autogenous bone grafts, the calvarial bone graft possesses many more advantages, including greater recipient site stability and less donor site morbidity. In addition, the surgical wound is hidden behind the hair line, which increases esthetic appearance for the patient. The disadvantages of the procedure are the thinner bone volume in the donor site and possible damage to the dura mater. The risk during harvesting the calvarial bone graft can be decreased by using piezoelectric appliance. In maxillofacial trauma patients, the calvarial bone provides a source of bone graft for reconstruction of large facial bony defect.

並列關鍵字

calvarial bone graft ； autogenous bone graft ； maxillofacial trauma reconstruction