[Reconstruction of the frontobasal skull after tumor operations and trauma. Transplant selection and functional outcome].
Defects of the frontoorbital complex subsequent to extensive tumor surgery or severe trauma often result in aesthetic and functional disharmonies. The long-term results of rehabilitation related to different materials and techniques are the subject of this study. From 1974 to 1996 altogether 127 patients with bony defects of the orbit and/or the skull base underwent surgery. All patients' data were documented prospectively from 1984 onwards. The results following reconstruction with autologous calvarian transplants in 52 patients were compared to those of a control group which received iliac bone or PMMA implants. Eighty-one bony defects (64%) resulted from tumor resection; 37 patients (29%) suffered from the effects of trauma. In 67 cases (53%) reconstruction was performed primarily, in 51 cases (40%) secondarily. Free or pedicled soft-tissue transplants were necessary in order to separate the orbit and the neurocranium in 26% of the defects. On the other hand, small, isolated defects of the orbital roof (7%) were left without any reconstructive procedure. Contrary to the iliac bone grafts, the calvarian transplants resisted secondary resorption. Postoperative infections appeared in two cases; loss of transplants was avoided entirely in the group of calvarian reconstructions in contrast to the alloplasts. The selection of a suitable donor site area and rigid fixation with microplates led to excellent esthetic results even in cases with large defects.
Krüger
C
C
Klinik für Gesichts- und Kieferchirurgie, Universitätsklinikum Essen.
Mohr
C
C
Stolke
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000379:methods*; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D005624:Frontal Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D019919:Prosthesis Implantation; D019291:Skull Base / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D019904:Polymethyl Methacrylate
Rekonstruktion der Frontobasis nach Tumoroperationen und Traumen. Transplantatauswahl und funktionelle Ergebnisse.