1
|
Bao M, Paka Lubamba G, Hua Y, Zhang G, Wang M, Gao N, Li C. Reconstruction of Extensive Maxillary Defects Using Flow-Through Fibula Free Flap With Anterolateral Thigh Free Flap. J Craniofac Surg 2024; 35:1268-1271. [PMID: 38437499 DOI: 10.1097/scs.0000000000010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/03/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The maxillary defects left unreconstructed or inadequately reconstructed often result in significant functional and esthetic impairments. Adequate reconstruction of extensive maxillary defects requires a sufficient volume of hard and soft tissues. METHODS A 48-year-old male presenting bilateral extensive maxillary defects underwent secondary reconstruction with a flow-through fibula free flap in combination with an anterolateral thigh free flap. RESULTS The use of flow-through technique allowed minimizing the problem of limited recipient vessels and the length of free flap vascular pedicle usually encountered in secondary reconstruction. The bilateral maxillary defects were successfully reconstructed, and the postoperative outcomes were uneventful. The patient was satisfied with the treatment outcomes. He is being followed up and was referred to the implantology department for the placement of osseointegrated dental implants. CONCLUSIONS The flow-through fibula free flap, in combination with the anterolateral thigh free flap, was found reliable and feasible for this case of secondary reconstruction of bilateral maxillary defects. This technique has provided satisfactory functional and esthetic outcomes and effectively improved the patient's self-esteem.
Collapse
Affiliation(s)
- Mingzhe Bao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Grace Paka Lubamba
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hospital of the University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Yufei Hua
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Gaowei Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Miao Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ning Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Comparison of Static and Dynamic Navigation in Root End Resection Performed by Experienced and Inexperienced Operators: An In Vitro Study. J Endod 2023; 49:294-300. [PMID: 36528176 DOI: 10.1016/j.joen.2022.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This study aimed to compare the effects of static navigation (SN), a dynamic navigation system (DNS), and the freehand (FH) technique in root end resection and the differences between these effects according to the level of experience of the operator. METHODS Maxillary models reconstructed with Mimics software (Materialise, Leuven, Belgium) were 3-dimensionally printed and divided according to the experimental technique (FH, SN, or DNS) and the operator (experienced or inexperienced). SN was designed using 3-matic Medical software (Materialise) and printed, and a surgical approach plan for DNS was established and performed using DCARER (Suzhou, China) software. The accuracy, efficiency, and safety of the resections were assayed. RESULTS The length, angle, volume, and depth deviations of the root end resections were significantly lower in the SN and DNS group compared with the FH group. SN significantly improved the efficiency of both operators, whereas DNS only improved the efficiency of the inexperienced operator. No difference between the SN and DNS groups was found, except for the time required for the surgery. No mishaps occurred during surgery in the SN or DNS group. The number of mishaps with the FH technique when used by the inexperienced operator was significantly higher than that registered for the rest of the groups. No interaction effect between technique and operator experience level was detected. CONCLUSIONS Regardless of operator experience, both SN and DNS could improve the accuracy and safety of root end resection. SN significantly improved the chairside efficiency of both operators, whereas DNS was more helpful for the inexperienced operator.
Collapse
|
3
|
Djorić I, Trivić A, Barna M, Milić I, Marković B, Valjarević S, Marinković S. Multidetector CT of the Nasal Cavity and Paranasal Sinuses Variations in 73 Patients. Indian J Otolaryngol Head Neck Surg 2022; 74:4653-4665. [PMID: 36742686 PMCID: PMC9895468 DOI: 10.1007/s12070-021-02940-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
Detailed knowledge of the anatomy of the nasal cavity and paranasal sinuses is very important in the diagnosis of pathological processes, planning of endoscopic surgery, and radiologic guiding techniques during certain operations. Observational study. Clinic of Neurosurgery, Institute and Department of Anatomy and Pathology, Clinic and Department for Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine. Two heads with brains were serially cut in the axial and coronal planes. 73 individuals, who were enrolled among 1848 patients, underwent examination by multidetector computerized tomography. A nasal septal deviation was seen in 65.8%, and septal pneumatization in 11%. Superior concha pneumatization was observed in 1.4% of patients, middle concha bullosa in 30.2%, and its hypoplasia in 1.4%. The lamina papyracea dehiscence was also present in 1.4%. The uncinate process was absent in 1.4%, and it was pneumatized in 4.2%. Agger nasi cells were noticed in 34.3%, and Haller and Onodi cells in 20.7% each. The olfactory fossa was shallow in 9.7%, deep in 31.6%, and very deep in 58.9%. Absence of the frontal sinus was seen in 9.7%. The presellar type of the sphenoidal sinus was present in 11%, the sellar in 35.7%, and the postsellar in 53.5%. Hypoplasia of the maxillary sinus was revealed in 1.4%, and hyperpneumatization in 4.2%. The sinus floor was usually below the level (60.3%), at the same level (20.7%), or above the level of the nasal floor (19.2%). The bony septum within the sinus was seen in 52.1%. The presented data are of a great significance in order to avoid a misdiagnosis of the anatomic variations, to make a proper diagnosis of certain diseases, and for safe endonasal operations.
Collapse
Affiliation(s)
- Igor Djorić
- Faculty of Medicine, Clinic of Neurosurgery, Clinical Center of Serbia, Institute of Radiology, University of Belgrade, Dr. Kosta Todorović 4, 11000 Belgrade, Serbia
| | - Aleksandar Trivić
- Faculty of Medicine, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, University of Belgrade, Pasterova 2, 11000 Belgrade, Serbia
| | - Mina Barna
- Faculty of Medicine, Institute of Pathology, University of Belgrade, Dr. Subotić 1, 11000 Belgrade, Serbia
| | - Ivan Milić
- Faculty of Medicine, Clinic of Neurosurgery, Clinical Center of Serbia, University of Belgrade, Dr. Kosta Todorović 4, 11000 Belgrade, Serbia
| | - Branka Marković
- Department of Anatomy, Faculty of Sports and Physical Education, University of Belgrade, Blagoja Parovica 156, 11000 Belgrade, Serbia
| | - Svetlana Valjarević
- Department of Otorhinolaryngology With Maxillofacial Pathology, Faculty of Medicine, Clinical Hospital Center Zemun, University of Belgrade, Vukova 9, 200140 Zemun, Serbia
| | - Slobodan Marinković
- Faculty of Medicine, Institute of Anatomy, University of Belgrade, Dr. Subotić 4/2, 11000 Belgrade, Serbia
| |
Collapse
|
4
|
Hongyu L, Yulin L, Wanye T, Xiaoguang LI, Fenghe Z, Qing L. Structural and functional changes of nasal cavity and maxillary sinus in patients with skeletal class III malocclusion 1 year after bimaxillary surgery. Orthod Craniofac Res 2022. [PMID: 36404137 DOI: 10.1111/ocr.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE This study aimed to analyse changes in the nasal cavity and maxillary sinus structure and function in patients with skeletal class III malocclusion 1 year after bimaxillary surgery. MATERIALS AND METHODS In this study, cone-beam computed tomography (CBCT) images of 20 patients (10 men and 10 women; mean age 24.3 ± 3.4 years) with skeletal class III malocclusion who underwent Le Fort I osteotomy and bilateral sagittal split osteotomy were obtained before and 1 year after the surgery. CBCT data were stored opened with element 3D (E3D) to establish a nasal airway model (the paranasal sinus includes only the maxillary sinus). Ansys (ANSYS) software is used for simulation and analysis. RESULTS The maxillary sinus and nasal cavity volumes decreased significantly 1 year after the surgery. After surgery, the volume of nasal cavity decreased by 13.5%, and the average volume of maxillary sinus decreased by 7.8%. There was no significant difference in the degree of deviation of the septum and nasal cavity resistance, and air distribution in the maxillary sinus did not change. The nasal cavity wall shear stress change was similar to that before surgery. CONCLUSIONS The maxillary sinus volume and nasal cavity volume of patients with skeletal class III malocclusion changed significantly after bimaxillary surgery, but there was no significant change in nasal ventilation function 1 year after surgery.
Collapse
Affiliation(s)
- Li Hongyu
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China.,Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Liu Yulin
- Institute of Thermal Science and Technology, Shandong University, Jinan, China
| | - Tan Wanye
- Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University & Institute of Stomatology, Jinan, China
| | - L I Xiaoguang
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhang Fenghe
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China.,Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Li Qing
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China.,Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| |
Collapse
|
5
|
Martu C, Martu MA, Maftei GA, Diaconu-Popa DA, Radulescu L. Odontogenic Sinusitis: From Diagnosis to Treatment Possibilities-A Narrative Review of Recent Data. Diagnostics (Basel) 2022; 12:1600. [PMID: 35885504 PMCID: PMC9319441 DOI: 10.3390/diagnostics12071600] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 12/17/2022] Open
Abstract
The maxillary sinus is a structure at the border of specialties: otorhinolaryngology and maxillofacial surgery. Due to this fact, regarding etiology, it can be affected by both the rhinogenic and odontogenic path and can impose diagnostic difficulties. The etiopathogenic mechanisms that can affect the Schneiderian membrane are mainly inflammatory, iatrogenic, traumatic, and tumorous in nature. From a microbiological point of view, the bacteriology is polymorphic, including both aerobic and anaerobic species in acute OS, the predominating species in acute OS being aerobic, and in chronic anaerobic germs. The role of fungi in the determination of this pathology and in the production of the biofilm that leads to resistance to antibiotic treatment is also discussed. The present paper aims to present the etiopathogenesis, bacteriology, clinical manifestations, as well as treatment of odontogenic sinusitis (OS) from an updated perspective through reviewing the literature. If unilateral maxillary sinusitis is usually due to odontogenic causes, this does not clinically exclude the possibility of strictly rhinogenic causes in the occurrence of sinusitis. This underlines the important role of complex oral and rhinological clinical examination as well as the role of preclinical examinations in specifying the certainty diagnosis. Simple radiography, orthopantomography, CT, and CBCT are compared in terms of diagnostic accuracy. The treatment of OS is complex, involving medication, dental, and surgical measures. The value of endoscopic surgery is emphasized, comparing its advantages over the classic Caldwell-Luc technique.
Collapse
Affiliation(s)
- Cristian Martu
- ENT Clinic Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania; (C.M.); (L.R.)
| | - Maria-Alexandra Martu
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
| | - George-Alexandru Maftei
- Department of Dento-Alveolar Surgery and Oral Pathology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania
| | - Diana Antonela Diaconu-Popa
- Department of Oral Implantology, Removable Dentures and Technology, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania;
| | - Luminita Radulescu
- ENT Clinic Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, Universitatii Street 16, 700115 Iasi, Romania; (C.M.); (L.R.)
| |
Collapse
|