深冻辐射灭菌同种异体大块下颌骨移植的临床应用

A CLINICAL OBSERVATION OF BLOCK FREEZE-IRRADIATED ALLOGENEIC MANDIBLE TRANSPLANTATION

目的 探讨深低温冷冻放射辐照同种异体大块下颌骨移植的临床方法和价值。方法 采用深冻同种异体下颌骨置换 10例大块病变下颌骨 ,术中尽可能保留植骨床骨膜 ,植骨块去除一侧部分皮质 ,并在保留皮质上打孔 ,浸泡抗生素液 ,骨松质区放置自体髂嵴松质骨和骨髓 ,严密缝合口腔粘膜 ,口外放置引流。结果 所有病例术后随访 12～ 3 0月 ,X线平片见宿主骨与移植骨生长愈合良好 ,未出现明显的高度降低 ,ECT显示植入骨有骨盐代谢。结论 深冻辐照同种异体大块下颌骨可用于下颌骨缺损的修复。

Objective To study the clinical value and methods of block freeze-irradiated allogenic mandible transplantation. Methods The replacement of block freeze-irradiated allogenic mandible had undergone in 10 patients with benign mandibular lesion. The host mandibular periosteum were retained, and lingual cortex of graft bone was cut. Punching some pores on the buccal cortex, marinating the shaped allogenic bone into antibiotic solusion for 5 minutes, we put some cancelli and bone marrow in the cancellous side from iliac crest, sutured the oral mucosa wound and drained. Results Follow-up from 12 months to 30 months postoperatively showed that 10 cases gained good contours and functions. X-ray indicated that the height of grafted bone was kept, ECT showed grafted bone had metabolized. Conclusion The block freeze-irradiated allogenic mandible could offer a good maxillofacial appearance and a strong bone support, it could play a valuable and reliable role in reconstruction of mandibular defects.