Rib Composite Flap With Intercostal Nerve and Internal Thoracic Vessels for Mandibular Reconstruction
نویسندگان
چکیده
PURPOSE The purpose of this study was to present the outcome and discuss the feasibility of rib composite flap with intercostal nerve and internal thoracic vessels for reconstructing mandibular defect. METHODS Rib composite flaps have been used in 82 patients for reconstructing benign tumor-caused large mandibular defects: 66 of the 82 patients were reconstructed using rib composite flap with intercostal nerve and internal thoracic vessels, whereas the other 16 patients were reconstructed using rib composite flap with internal thoracic vessels, without intercostal nerve. After operation, clinical observation, imageological examination, and sensory detection were used to evaluate the effect of reconstruction. RESULTS All rib composite flaps with intercostal nerve and internal thoracic vessels were successfully harvested and transplanted. Both immediate and long-term examination showed good appearance reconstruction. All followed-up patients conveyed good satisfaction degree with function and appearance reconstruction. Postoperative panoramic x-ray examination showed new bone formation between the transplanted rib and mandibular stump. Good recoveries of mandibular nerve sensory were observed when followed up after reconstruction surgery. CONCLUSIONS Rib composite flap with intercostal nerve and internal thoracic vessels could be a promising method for reconstruction of mandibular defects.
منابع مشابه
Analgesia requirements in patients undergoing DIEP flap breast reconstructions: rib preservation versus rib sacrifice.
Figure 1 Intraoperative photograph of a right 2nd intercostal space showing the IMVs successfully anastomosed to the deep inferior epigastric vessels. The distance between the two ribs and thus the space available for the microvascular anastomoses was 19 mm. Internal mammary vessel (IMV) exposure for free-flap breast reconstruction (BR) traditionally entails removal of a segment of the 3rd cost...
متن کاملA New Method of Limb Salvage and Functional Upper Limb Reconstruction
Amputation is frequently used to treat malignant tumors invading into the shoulder joint. When the vessels and major nerves of the upper arm are preserved, however, the limb may be salvaged with a combined osseous, myocutaneous flap. We reconstructed large defects, which included the shoulder joint, using a vascularized rib-latissmus dorsi combined flap. Ribs were connected via the ninth or ten...
متن کاملReconstruction of an emergency thoracotomy wound with free rectus abdominis flap: Anatomic and radiologic basis for the surgical technique
An alcoholic 50-year-old male patient with a history of schizophrenia sustained stab wounds into both ventricles and left lung, and survived following an emergency department thoracotomy. The EDT wound, however became infected requiring serial debridements of soft tissue, rib cartilage and sternum. Regional flap options such as pectoralis major and latissimus dorsi muscle flaps could not be emp...
متن کاملA case of bifid rib and additional intercostal space
Introduction The thoracic cage is made up of twelve vertebrae, sternum and twelve pairs of ribs. The ribs articulate with the vertebrae posteriorly and with the sternum through the corresponding costal cartilages anteriorly. The spaces between the adjacent ribs are called intercostal spaces. There are 11 intercostal spaces on each side. The intercostal spaces are filled with three layers of int...
متن کاملBifid Rib: Anatomical Considerations in Three Cases
The present study involved a detailed investigation of 3 cases of bifid rib, focusing on anatomical features, and classified them into 2 types. The bifid ribs were in the right fourth rib of all 3 male cadavers. The upper intercostal spaces of the fourth bifid rib were considerably narrowed, whereas the lower intercostal spaces were widened. Although the size and shape of the bifid space betwee...
متن کامل