Johannes Hachleitner

Paracelsus Medical University Salzburg, Salzburg, Salzburg, Austria

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Publications (6)11.44 Total impact

  • Christian Brandtner · Heinz Bürger · Johannes Hachleitner · Alexander Gaggl
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    ABSTRACT: New techniques in microvascular flap transfer result in new indications for reconstructive treatment of facial defects. In this study, the indications and success rate of an intraoral anastomosing technique in facial reconstruction were examined. Seventy patients with intraoral defects or central midface defects were reconstructed with the use of microvascular flaps. Anastomoses were performed by an intraoral anastomosing technique. Indications for the use of this technique, types of flaps, complications and problems were evaluated. Except for 5 reconstructions, all were performed to correct bone defect coverage of the jaws. All anatomising procedures worked without severe intraoperative problems. There was one total flap loss caused by venous congestion, and two partial losses not associated with the anastomosing technique. There were no other complications or problems. The main indications for the use of intraoral anastomosing techniques are alveolar ridge reconstruction in patients with defects not caused by a malignant tumour and central midface reconstruction in the case of short flap pedicle. The success rate of the intraoral anastomosing technique is similar to that of extraoral techniques reported in the literature. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
    Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 08/2015; DOI:10.1016/j.jcms.2015.07.017 · 2.93 Impact Factor
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    ABSTRACT: Two-jaw surgery has become the standard procedure for correcting skeletal maxillo-mandibular discrepancies in adults. However, only a few studies have reported on the long-term stability of bimaxillary orthognathic surgery in patients with Class II malocclusion and transverse discrepancies. In this study, the long-term outcome of two-piece maxillary treatment during bimaxillary surgery in patients with skeletal Class II malocclusion was examined and the results are discussed. Dental plaster casts and lateral cephalograms of 47 patients were collected in five phases of treatment: baseline (t1), preoperatively (t2), postoperatively (t3), at the end of orthodontic treatment (t4), and at the time of long-term follow-up (t5), and were retrospectively analyzed. At follow-up all patients showed a Class I occlusion. The maxillary width was, on average, enlarged by 2.7 mm surgically. During the following 8.8 years after treatment, 1.7 mm were lost. The cephalometric analyses showed no severe changes in the sagittal maxillary position for the duration of follow-up. The sagittal mandibular position (SNB) was changed significantly by the mandibular advancement from 75.4° to 77.8° and remained stable for 8.8 years postoperatively. Bimaxillary surgery with two-piece maxillary treatment in patients with Class II malocclusion leads to stable long-term occlusal results in the sagittal plane. The transverse enlargement achieved by intraoperative widening does not remain stable over the years. A relapse of about 60% of the surgically expanded transverse width is seen. In Class II deformities without an open bite, where extended transverse enlargement is necessary, a two-step procedure with primary surgically-assisted rapid palatal expansion followed by one-piece surgery should be planned. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
    Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 07/2015; 43(8). DOI:10.1016/j.jcms.2015.07.007 · 2.93 Impact Factor
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    C Brandtner · J Hachleitner · H Buerger · A Gaggl
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    ABSTRACT: In midface defects including the orbit (Brown class III and IV), no single flap can provide adequate reconstruction. In this technical note, the combination of vascularized iliac crest flap and vascularized medial femoral condyle flap (MFC) is described. The vascularized iliac crest flap is reported to be the gold standard for maxilla reconstruction. There is, however, no consensus on the best method for orbital and nasal wall reconstruction. The MFC flap can be harvested as a thin corticoperiosteal flap or as an osteomyocutaneous flap. Due to the periosteal blood supply, this flap can be customized for an individual defect of the upper hemi-midface. It is therefore of great benefit in orbital and nasal wall reconstruction. By combining the deep circumflex iliac artery (DCIA) bone flap and the MFC flap, the best standard reconstruction technique of the hemi-maxilla can be combined with a new anatomical precise microvascular reconstruction technique of the orbit. A nearly symmetric midface appearance can be achieved. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
    International Journal of Oral and Maxillofacial Surgery 03/2015; 44(6). DOI:10.1016/j.ijom.2015.03.006 · 1.57 Impact Factor
  • Farzad Borumandi · Alexander Gaggl · Johannes Hachleitner
    Orbit (Amsterdam, Netherlands) 02/2014; 33(4). DOI:10.3109/01676830.2014.881402
  • Johannes Hachleitner · Simon Enzinger · Christian Brandtner · Alexander Gaggl
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    ABSTRACT: The role of the titanium functionally dynamic bridging plate (TFDBP) in the fracture treatment of the severely atrophic mandible was assessed retrospectively. In 28 consecutive patients with fractures of a severely atrophic mandible fixation was carried out with TFDBPs. Twenty-one patients with 27 fractures were included in the study and then followed up for complications and the progress of fracture healing for 17 months postoperatively on average. There was only one case that required plate removal. All patients showed bone healing 3 months after surgery. The mental nerve sensation improved in 12 out of 23 fractures that had presented with nerve function disturbance. Every patient who had dentures prior to sustaining the fracture was able to return to denture wearing 3 weeks after surgery. No major complications occurred. A high proportion of bone healing with a low complication rate was observed with the use of TFDBPs in the treatment of severely atrophic mandible fractures. The TFDBP is an excellent alternative to conventional plating of the severely atrophic mandible.
    Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 08/2013; 42(5). DOI:10.1016/j.jcms.2013.05.037 · 2.93 Impact Factor
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    ABSTRACT: We report the first clinical use of a free microvascular thenar flap for reconstruction of intraoral soft tissues. In 9 patients with a recurrent oral squamous cell carcinoma (SCC), a new primary oral SCC, or a defect of the hard palate after radiotherapy, we covered the soft tissue defect, after resection of the tumour or local preparation, with a microvascular thenar flap. All patients had had combined resection and irradiation for treatment of the initial tumour. In every case the thenar flap was harvested from the left forearm. Arteries were anastomosed to cervical arteries on either side. The veins were anastomosed to the deep jugular or subclavian vein. Patients were followed up clinically after 3, 6, and 12 months and radiologically every 6 months. The mean length of the pedicle was 21cm. The mean width of the flap was 27mm (range 24-30) and the mean length 37mm (range 26-49). All anastomoses worked well. All flaps healed without major complications. A thin but stable layer of soft tissue resulted in every case. All patients were able to wear their prostheses. Good functional and aesthetic results were seen at each follow-up visit, and there were no signs of relapse. The microvascular thenar flap is well-suited for reconstruction of thin layers of soft tissue in the oral cavity. The long pedicle and hairlessness are also ideal for covering intraoral defects after previous operations and in necks with few if any vessels. Primary wound closure is possible in many cases.
    British Journal of Oral and Maxillofacial Surgery 02/2012; 50(8). DOI:10.1016/j.bjoms.2012.02.001 · 1.08 Impact Factor