Application of high-tech three-dimensional imaging and computer-generated models in complex facial reconstructions with vascularized bone grafts.

Abstract:

:We present a series of six patients with eight flaps in whom computer-generated models were used for fabrication of vascularized bone grafts in complex facial restorations. Preoperative CT data, digitalized on tape, were converted by the CEMAX (Santa Clara, Calif.) 1500 Integrated Hardware and Software System to a three-dimensional visualization of the bone and soft-tissue deficiencies. These data were transmitted by direct computer link to a CNC milling machine that produced full-size slices "stacked" into a three-dimensional template. The acrylic replica aided selection of appropriate donor sites and intraoperative "carving" of bone transfers. Reconstructions included three zygomas, two maxillae, two mandibles, and one frontal bone. Donor sites were iliac crest, scapula, and outer calvarium. Four were free flaps and four island pedicle flaps. All healed without infection. Bone resorption was less than 10 percent. One flap was lost to thrombosis. Other complications included a transient facial palsy in one patient and temporary radial palsy from shoulder traction in another. Computer-generated templates for vascularized grafts are expensive and thus are not indicated or necessary in every patient. The advantages, however, are several. Custom models facilitate preoperative planning, with less guesswork of size, contour, and orientation of the graft, which is especially desirable with vascularized grafts, since the position of the pedicle is critical. Anesthesia time is decreased. Grafts can be fitted exactly, without reshaping and "nibbling." Nuances of depth and tapering are directly carved into the bone. By merging high-tech imaging and microsurgery, the best chance of optimal results can be achieved.

journal_name

Plast Reconstr Surg

authors

Rose EH,Norris MS,Rosen JM

doi

10.1097/00006534-199302000-00007

subject

Has Abstract

pub_date

1993-02-01 00:00:00

pages

252-64

issue

2

eissn

0032-1052

issn

1529-4242

journal_volume

91

pub_type

杂志文章
  • Management of Stenosing Flexor Tenosynovitis: Maximizing Nonoperative Success without Increasing Morbidity.

    abstract:BACKGROUND:Traditional nonoperative management of stenosing tenosynovitis is limited to one corticosteroid injection, followed by surgery in the case of failure. Recently, nonoperative strategies have been extended to include two or three injections despite the absence of large prospective studies supporting this pract...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000475789.46608.39

    authors: Golas AR,Marcus LR,Reiffel RS

    更新日期:2016-02-01 00:00:00

  • Health-related quality-of-life assessment and surgical outcomes for auricular reconstruction using autologous costal cartilage.

    abstract:BACKGROUND:This study aims to assess the health-related quality-of-life benefit following auricular reconstruction using autologous costal cartilage in children. In addition, key aspects of the surgical reconstruction are assessed. METHODS:After auricular reconstruction, patients completed two questionnaires. The firs...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182402ca7

    authors: Soukup B,Mashhadi SA,Bulstrode NW

    更新日期:2012-03-01 00:00:00

  • Monoclonal antibody to intercellular adhesion molecule 1 protects skin flaps against ischemia-reperfusion injury: an experimental study in rats.

    abstract::The purpose of this study was to evaluate the blockage of polymorphonuclear neutrophil endothelial adhesion by using a monoclonal antibody to the intercellular adhesion molecule 1 (ICAM-1) ligand to prevent ischemia-reperfusion injury in rat skin flaps. A skin and subcutaneous tissue flap (3.0 cm x 4.5 cm) supplied by...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199805000-00023

    authors: Tosa Y,Lee WP,Kollias N,Randolph MA,May JW Jr

    更新日期:1998-05-01 00:00:00

  • Biostereometrics and computergraphics for patients with craniofacial malformations: diagnosis and treatment planning.

    abstract::Utilizing the techniques of biostereometric photography and current state-of-the-art computergraphics, topographic contourgrams have been generated in a series of patients with complex craniofacial malformations. These contourgrams are considered useful in diagnosis and treatment planning and as an aid in postoperativ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198504000-00007

    authors: Sen Savara B,Miller SH,Demuth RJ,Kawamoto HK

    更新日期:1985-04-01 00:00:00

  • Combined tissue expansion: clinical attempt to decrease pain and shorten placement time.

    abstract::Tissue expansion can be characterized as a unique reconstructive procedure that takes advantage of the intrinsic ability of tissues to stretch and, in some instances, to grow in response to expansive forces. The efficacy of combined intraoperative expansion to obtain sufficient expanded tissue more rapidly was tested ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Iwahira Y,Maruyama Yu

    更新日期:1993-03-01 00:00:00

  • Prevention of microvascular thrombosis by topical application of recombinant tissue factor pathway inhibitor.

    abstract::Tissue factor pathway inhibitor is a naturally occurring protein inhibitor of factor X and the tissue factor-factor VII complex of the extrinsic pathway of coagulation. The potential of tissue factor pathway inhibitor as a topical antithrombotic agent was evaluated in a rabbit model of thrombosis that combined intimal...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199603000-00015

    authors: Lantieri LA,Ozbek MR,Deune EG,Ornberg RL,Brown DM,Chung SH,Wun TC,Cooley BC,Khouri RK

    更新日期:1996-03-01 00:00:00

  • Techniques of monitoring buried fasciocutaneous free flaps.

    abstract:BACKGROUND:Although postoperative monitoring of microsurgical reconstruction is key to discovering early vascular compromise, monitoring a buried flap can be problematic. METHODS:A single surgeon's tracheal and pharyngoesophageal reconstructions with fasciocutaneous free flaps performed between 2002 and 2007 are revie...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318196b9a3

    authors: Ferguson REH Jr,Yu P

    更新日期:2009-02-01 00:00:00

  • The dual role of perichondrium in cartilage wound healing.

    abstract::Cartilage structures from the head and neck possess a certain but limited capacity to heal after injury. This capacity is accredited to the perichondrium. In this study, the role of the inner (cambium) and the outer (fibrous) layers of the perichondrium in cartilage wound healing in vitro is investigated. For the firs...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.PRS.0000020991.10201.6C

    authors: Duynstee ML,Verwoerd-Verhoef HL,Verwoerd CD,Van Osch GJ

    更新日期:2002-09-15 00:00:00

  • Diced cartilage grafts in rhinoplasty surgery.

    abstract::The use of diced cartilage grafts in rhinoplasty surgery was recently revived by Erol with the publication of his technique for "Turkish delight" grafts (i.e., diced cartilage grafts wrapped in Surgicel). The present study details the authors' experience with 50 consecutive diced cartilage grafts used in three configu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000122544.87086.b9

    authors: Daniel RK,Calvert JW

    更新日期:2004-06-01 00:00:00

  • The axial nasodorsum flap.

    abstract::A new axial flap is described for reconstruction of soft-tissue defects of the nose, including the supratip and columella. The blood supply to this flap originates from the lateral nasal branch of the angular artery adjacent to the nasolabial fold. This flap was used in seven patients between 1989 and 1994, and there ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199706000-00010

    authors: Maruyama Y,Iwahira Y

    更新日期:1997-06-01 00:00:00

  • The effect of chemosurgical peels and dermabrasion on dermal elastic tissue.

    abstract::Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alte...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199708000-00035

    authors: Giese SY,McKinney P,Roth SI,Zukowski M

    更新日期:1997-08-01 00:00:00

  • Face lifts with hidden scars: the vertical U incision.

    abstract::The authors present their latest development of a strictly vertical retroauricular incision to minimize a sequela of a face lift, namely, a visible scar. The temporal preauricular vertical incision and the retroauricular vertical incision form two parallel arms of a U-shaped incision. Anteriorly, a downward rotation f...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200206000-00058

    authors: Marchac D,Brady JA,Chiou P

    更新日期:2002-06-01 00:00:00

  • Does the gatekeeper model work in hand surgery?

    abstract:BACKGROUND:Most managed care plans use a physician "gatekeeper" to control referrals to hand surgeons. The appropriateness of this model for upper extremity complaints has never been challenged. The purpose of this study was to evaluate the prior management of patients with elective hand disorders who present to a hand...

    journal_title:Plastic and reconstructive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/PRS.0b013e31829acc74

    authors: Hartzell TL,Shahbazian JH,Pandey A,Girson LA,Rubinstein R,Bojovic B,Bernthal N,Azari KK,Benhaim P

    更新日期:2013-09-01 00:00:00

  • Restoring tactile and erogenous penile sensation in low-spinal-lesion patients: procedural and technical aspects following 43 TOMAX nerve transfer procedures.

    abstract:BACKGROUND:The "TOMAX" (TO MAX-imize sensation, sexuality, and quality of life) procedure restores genital sensation in men with low spinal lesions, improving sexual health, as shown previously. It connects the dorsal nerve of the penis to the intact ipsilateral ilioinguinal nerve, unilaterally or bilaterally. This stu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/PRS.0000000000000406

    authors: Overgoor MLE,de Jong TPVM,Kon M

    更新日期:2014-08-01 00:00:00

  • The vascularized pig fibula bone flap model: effects of multiple segmental osteotomies on growth and viability.

    abstract::Previous work by this laboratory introduced the pig fibula bone flap as a model for the study of the pathophysiology of vascularized bone flaps. Anatomic and hemodynamic studies demonstrated a significant (p < 0.05) decrease in vascular perfusion after a series of segmental osteotomies and rigid fixation (lag screws a...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199904050-00012

    authors: Gur E,Chiodo A,Pang CY,Mendes M,Pritzker KP,Neligan PC,Shpitzer T,Forrest CR

    更新日期:1999-04-01 00:00:00

  • A clinical trial in facial fat grafting: filtered and washed versus centrifuged fat.

    abstract:BACKGROUND:Although the increasing trend is to rebuild facial soft-tissue volume with autologous fat transfer, there is no agreement concerning the best way of processing the harvested fat before reinjecting it. Among all the reported fat graft processing techniques, in the present study, the authors compared the clini...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182131d5d

    authors: Botti G,Pascali M,Botti C,Bodog F,Cervelli V

    更新日期:2011-06-01 00:00:00

  • Correction of asymmetries of the breasts.

    abstract::The problem of asymmetries of the breasts is discussed. The technical details of one operation for unilateral reduction are described. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197606000-00003

    authors: Elsahy NI

    更新日期:1976-06-01 00:00:00

  • The effect of perioperative adriamycin on skin-graft take and adherence in the rat.

    abstract::This two-part study was undertaken to evaluate the effect of perioperative Adriamycin on skin-graft take and adherence in an animal model. Thirty-four male Fisher rats were divided into control and experimental groups. The controls received intravenous saline, and the experimental animals received Adriamycin 6 mg/kg (...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Nappi JF,Falcone RE,Ruberg RL,Innes JA

    更新日期:1984-09-01 00:00:00

  • The reverse-flow posterior tibial artery island flap: anatomic study and 72 clinical cases.

    abstract::Based on anatomic, dye injection, and angiography observations since 1984, 72 patients with tissue defects of the foot (due to injury or surgery) have been reconstructed using a reverse-flow posterior tibial artery island flap. In the 72 patients, etiology has included extensive crushing (40 patients), burn scars (10 ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Liu K,Li Z,Lin Y,Cao Y

    更新日期:1990-08-01 00:00:00

  • Toe-to-hand transfer.

    abstract::Toe-to-hand transfer was performed in 28 patients, involving 33 fingers, using microvascular technique. Of this number, 26 patients (31 fingers) had experienced trauma, and the remaining 2 patients (2 fingers) had a congenital deformity. The toew used for grafting were the great toe (1), the second tow (30), and thir...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198007000-00015

    authors: Yoshimura M

    更新日期:1980-07-01 00:00:00

  • Palmar shelf arthroplasty, the next generation: distraction/interposition for rheumatoid arthritis of the wrist.

    abstract::Rheumatoid arthritis affects approximately 1 percent of the adult population. Bilateral symmetric involvement of the wrist occurs in 85 percent of these patients, with recurrent flares and relentless progression. Anatomic changes consist of radiocarpal, intercarpal, and radioulnar subluxation and joint destruction. Fo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199912000-00018

    authors: Skoff H

    更新日期:1999-12-01 00:00:00

  • Reconstruction of infant thoracic wounds.

    abstract::From 1985 through 1987, five of eight infants with thoracic wounds at Yale-New Haven Hospital underwent chest-wall reconstruction. In total, the eight infants underwent 17 procedures (including multiple open resuscitations) exclusive of the reconstructive operations. Patients undergoing reconstruction ranged from 1 to...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198812000-00010

    authors: Stahl RS,Kopf GS

    更新日期:1988-12-01 00:00:00

  • The thoracodorsal artery perforator flap in the treatment of axillary hidradenitis suppurativa: effect on preservation of arm abduction.

    abstract:UNLABELLED:Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesion...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182268c38

    authors: Busnardo FF,Coltro PS,Olivan MV,Busnardo APV,Ferreira MC

    更新日期:2011-10-01 00:00:00

  • Reconstruction of Philtrum Using Partial Splitting and Folding of Orbicularis Oris Muscle in Secondary Unilateral Cleft Lip.

    abstract:BACKGROUND:The reconstruction of the philtrum during unilateral cleft lip repair remains a surgical challenge. The authors introduce a modified surgical technique for the reconstruction of the philtrum that allows for both the deepening of the philtral dimple and augmentation of the philtral ridge. METHODS:Between Jan...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000001795

    authors: Li L,Xie F,Ma T,Zhang Z

    更新日期:2015-12-01 00:00:00

  • Mitochondrial activity of orbicularis oris muscle in unilateral cleft lip patients.

    abstract::To better evaluate the role of a possible mitochondrial alteration in the pathogenesis of cleft lip, we obtained and examined 38 orbicularis oris muscle specimens taken from the cleft margin of both cleft and noncleft sides of 10 unilateral cleft lip infants at the time of primary closure. Part of each sample was froz...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199809040-00005

    authors: Raposio E,Bado M,Verrina G,Santi P

    更新日期:1998-09-01 00:00:00

  • Liposuction-assisted posterior brachioplasty: technical refinements in upper arm contouring.

    abstract:BACKGROUND:Brachioplasty has increased 4059 percent from 2000 to 2008 in the United States, with 14,059 upper arm lift procedures performed in 2008. Numerous variations in the evolution of brachioplasty have been described to improve on complications and outcomes. Liposuction-assisted posterior brachioplasty is the nex...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181ebe23c

    authors: Nguyen AT,Rohrich RJ

    更新日期:2010-10-01 00:00:00

  • Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial.

    abstract:BACKGROUND:Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making. METHODS:Women (n = 2...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/PRS.0000000000002538

    authors: Sherman KA,Shaw LE,Winch CJ,Harcourt D,Boyages J,Cameron LD,Brown P,Lam T,Elder E,French J,Spillane A,BRECONDA Collaborative Research Group.

    更新日期:2016-10-01 00:00:00

  • Nationwide Cost Variation for Thumb Replantation: A Population Study.

    abstract:BACKGROUND:Health care reforms aimed at bundling payments attempt to contain costs. Uncovering variation in spending provides one strategy for decreasing expenditure. This study aims to investigate interhospital cost variation for thumb replantation. METHODS:A retrospective cross-sectional analysis of patients undergo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006022

    authors: Billig JI,Zhong L,Chung KC

    更新日期:2019-10-01 00:00:00

  • Pyoderma gangrenosum: skin grafting after preparation with hyperbaric oxygen.

    abstract::Four patients with pyoderma gangrenosum were treated with hyperbaric oxygen to prepare the wounds for skin grafting. Each wound responded to a course of daily hyperbaric oxygen with reduction of infection and increased capillary angiogenesis. During follow-up periods of 12 to 30 months, all wounds remained healed. Alt...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Davis JC,Landeen JM,Levine RA

    更新日期:1987-02-01 00:00:00

  • Coverage of heel and sole defects: a new subfascial arterialized flap.

    abstract::Defects of the heel and sole represent difficult reconstructive problems in terms of tissue availability and postoperative morbidity. Although local flaps offer the optimal type of coverage, their application has been restricted to defects of limited size. A study of the plantar skin and fascia, as well as its neurova...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198008000-00014

    authors: Reiffel RS,McCarthy JG

    更新日期:1980-08-01 00:00:00