扩张器持续压力对额骨影响的临床观察

Clinical study on effects of progressive pressure of tissue expanders on frontal bone

目的:观察额部扩张器持续压力对额骨的形态学影响。方法:2010年1月～2012年8月对58例鼻缺损患者采用扩张的额部皮瓣行全鼻或半鼻再造术,一期在额部埋置扩张器,在扩张器置入前、扩张器取出时、扩张器取出后6个月,观察扩张器持续压力下额骨形态的的变化。结果:所有患者额骨都出现了较明显的变形,尤其是在扩张器基底深面的额骨,可见明显的骨吸收所致的凹陷畸形,而在扩张器周边,则出现了增生的纤维包膜,这些表现在年轻患者身上表现的更为显著。术后随访6～24个月,所有患者额部基本恢复术前正常形态。结论:额部扩张器持续压力造成的额骨变形是暂时的,在压力去除后变形的额骨都是可以恢复正常的。

Objective To summarize the morphological changes of tissue expanders on the frontal bone,and observe if the deformed frontal bone can be healing to normalized before.Methods From Junuary 2010 to August 2012,nasal reconstruction were performed in 58 patients with total nasal defects using expanded forehead flap.Among the patients,35 are males and 23 are females,the age arrange from 5-39 years old,mean age were 21 years old.The follow-up period were from 6 months to 24 months.Results All the patients have significant changes of frontal bones,especially beneath the tissue expanders and at the periphery of the tissue expanders.Concavity due to bone deposition occurs beneath the tissue expanders in all cases.At the border around the expanders is an area of hyperplasia of fibrous capsule.These findings appeared more pronounced in the younger patients.Conclusion The deformations of frontal bone resulted from progressive pressure is temporary,it can be normalized when the pressure was removed with the time going.