Nasofacial Reconstruction with Calvarial Bone Grafts in Compromised Defects
ABSTRACT To determine the utility of calvarial bone grafting in multiple reconstructive settings. In particular to examine the success of calvarial bone grafting of the nasofacial skeleton in a compromised wound bed.
A retrospective review was performed to identify patients undergoing calvarial bone graft reconstruction of the nasofacial skeleton. Patients were identified from operative records and the medical record was reviewed to identify age, gender, site of defect, indication for the operation, size of bone graft harvested, postoperative and delayed complications, radiation exposure, need for additional soft tissue, and graft loss.
Eighty-seven patients who underwent split calvarial bone grafts were identified and had a complete medical record available for review. Ninety grafts were harvested. Five subsites in the nasofacial skeleton were identified as sites for reconstruction. Forty cases were performed for revision of a previous complication, including 13 who had a previous alloplastic implant. Twenty-four additional cases were performed in a compromised wound bed and 64% of all cases were performed in either a revision or compromised setting. There was an 11% incidence of early postoperative complications, but there were no major complications at the donor site and only two major complications at the recipient site.
Calvarial bone is a very useful material in the primary, revision, and compromised settings. This series suggests that split calvarial bone grafts is an adaptable, durable, and reliable material. It can be reliably used in the setting of radiation, infection, and inflammation.
- Quantum Electronics and Laser Science Conference, 1997. QELS '97., Summaries of Papers Presented at the; 06/1997
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ABSTRACT: For almost a century, autologous bone grafts are the criterion standard for facial skeleton rehabilitations. Progressively, because of its various advantages, calvarial bone imposed as one of the most adapted for craniomaxillofacial reconstructions. Also, calvarial harvesting remains a controversial technique because of its potential complications described in the literature. The aim of this study was to report the precocious and late complications encountered in our practice and to compare them with the previous data of the literature. We decided to realize a retrospective study over 10 years and 511 cases of calvarial bone harvesting performed in our maxillofacial department. Our results are very clear, reporting some annoying consequences and long-term aesthetic reattempts, but any serious complication. According to our experience and previous data of the literature, we described some technical refinements that could improve our technique and reduce its potentials complications. Nevertheless, we think that nowadays calvarial harvesting is the criterion standard for maxillofacial bone grafts, and the complications described in the literature are negligible for experienced operators.The Journal of craniofacial surgery 01/2011; 22(1):178-81. DOI:10.1097/SCS.0b013e3181f75300 · 0.68 Impact Factor
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ABSTRACT: Defects of the nasal dorsum or sidewall can result from trauma, congenital lesions, extirpation of neoplasms, or iatrogenic injuries. Simple techniques are often used to reconstruct defects in this area with excellent outcomes. Complex defects require more sophisticated techniques including multilayer closures using pedicled flaps or free tissue transfer. This review discusses key anatomic and functional principles and techniques to assist in planning for reconstruction of nasal dorsum and sidewall defects from any cause.Facial plastic surgery clinics of North America 02/2011; 19(1):13-24. DOI:10.1016/j.fsc.2010.10.011 · 1.18 Impact Factor