处理颌面弹道创伤的算法。临床病例及文献综述

Alfio Secchi-A, Sebastián Mordoh-C, Eric Cristi-R, Emilio Díaz-B, Gianfranco Passalacqua-M, Nicolás Yanine-M, José Barrios-T
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摘要

摘要:与高效人工插入的功能相比,弹道弹射性颌面部创伤具有高死亡率和发病率、高耗材成本、住院成本和资源成本等特点,对高度复杂的服务具有挑战性。从这个意义上说,重建手术与软组织和硬组织的损伤有关,分为直接阶段(切开复位和骨固定)和/或中间阶段,其中使用外部导师仍然是一个有效的建议。报告一名38岁男性患者因颌面部弹道创伤合并下颌骨体广泛软组织损伤和粉碎性骨折而入院,采用外部辅助物稳定治疗,随后采用非自体移植物重建。血管;术中出现口外、口内通路连通的并发症;用面颊脂肪体的局部皮瓣闭合。病人病情好转。文献综述进行了有关使用脂肪体的脸颊在重建颌面外科。使用外部辅导是一种有效和有利的替代创伤与广泛的损伤软硬组织。据报道,在口腔和颌面外科手术中,脸颊脂肪体的使用有多种用途,然而,它作为局部移植物用于需要移植的闭合过程的使用很少;在本报告中作为一项建议提出。
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Algoritmo para el Manejo del Trauma Balístico Maxilofacial. Caso Clínico y Revisión de la Literatura
˚ ABSTRACT: Ballistic projectile maxillofacial trauma corresponds to a challenging scenario for highly complex services due to high mortality and morbidity, associating high cost in supplies, hospitalization and resources, in contrast to the functionality towards efficient labor insertion. In this sense, reconstruction surgery is related to the damage presented in the soft and hard tissues, being classified in the immediate stage (open reduction and fixation with osteosynthesis) and / or mediate where the use of external tutors continues to be a valid proposal. Report of a 38-year-old male patient admitted for maxillofacial ballistic trauma with extensive soft tissue damage and comminution in the mandible body, being treated mediate by stabilization of external tutors and subsequent reconstruction with a non-autologous graft. vascularized; presenting intraoperative complication of communication between extraoral and intraoral access; closed with a locoregional flap of the adipose body of the cheek. The patient presents a favorable evolution. A literature review was carried out in relation to the use of the adipose body of the cheek in reconstructive maxillofacial surgery. The use of external tutors is presented as a valid and favorable alternative for trauma with extensive damage to soft and hard tissue. The use of the adipose body of the cheek is reported in various uses in oral and maxillofacial surgery, however, its use as a locoregional graft for closing processes that require grafting is scarce; it is presented as a proposal in this report.
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