Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review.

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
Sean A Knudson, Kristopher M Day, Patrick Kelley, Pablo Padilla, Ian X Collier, Steven Henry, Raymond Harshbarger, Patrick Combs
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引用次数: 0

Abstract

Study design: Retrospective case series; systematic review.

Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion.

Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis.

Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline.

Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

使用虚拟手术计划的同一入院微血管颌面弹道创伤重建:一个病例系列和系统回顾。
研究设计:回顾性病例系列;系统的回顾。目的:目前尚不清楚使用虚拟手术计划(VSP)促进急性颌面弹道创伤(MBT)后下颌骨的同院显微外科重建是否足以实现明确的重建和功能闭塞。方法:对急性MBT术后行VSP显微外科重建的患者进行单中心回顾性分析。采用盲法筛选对PubMed/MEDLINE、Embase、ScienceDirect和Scopus数据库进行系统回顾。通过专题分析对研究进行评价。结果:5例患者均采用VSP进行下颌骨显微外科重建。我们观察到从初次就诊到重建的平均时间为16.4±9.1天,平均住院时间为51.6±17.9天,每例患者手术6.2±2.8次,游离皮瓣1.6±0.9个。共使用4种皮瓣8个,最常见的是大腿前外侧皮瓣(37.5%)。护理使皮瓣完全存活。每位患者至少有1个轻微并发症。所有患者均达到中心闭塞、口腔营养和接近其基线面部美学。随访时间为191.0±183.9周。系统评价产生了8篇符合纳入标准的文章。在实施MBT重建时,文献中对VSP的临床目标和功能的主题是一致的,但在最佳治疗时间上却存在分歧。结论:MBT术后同院显微外科重建术能安全有效地重建下颌骨形态和功能。考虑到在确定重建之前需要做准备,VSP并没有延迟重建。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
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