Revascularization of free mandibular reconstruction after early emergency arterial ligation.
Abstract
A 70-year-old man with a squamous cell carcinoma involving the anterior arch and body of the mandible underwent resection and reconstruction with a 10-cm free vascularized iliac crest bone graft, preserving periosteum and minimal adjacent soft tissue. On postoperative day 12, he experienced bleeding from an orocutaneous fistula, requiring emergency ligation of the arterial pedicle to control hemorrhage. After ligation, continued bleeding was noted from the margin of the graft, with active filling of the venous pedicle. The 10-cm mandibular bone graft survived without appreciable resorption during a period of follow-up of 5 years. We believe that bone graft survival in the present case was due to early vascular communication between the periosteum and adjacent soft tissues of the graft with the recipient bed. This mechanism may serve to maintain bone graft viability after early arterial disruption, when repeat arterial anastomosis is believed to be contraindicated.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 해부 | mandible
|
하악골 | dict | 1 | |
| 해부 | soft tissue
|
scispacy | 1 | ||
| 해부 | graft
|
scispacy | 1 | ||
| 해부 | mandibular bone graft
|
scispacy | 1 | ||
| 해부 | periosteum
|
scispacy | 1 | ||
| 해부 | soft tissues
|
scispacy | 1 | ||
| 합병증 | orocutaneous fistula
|
scispacy | 1 | ||
| 합병증 | arterial pedicle
|
scispacy | 1 | ||
| 질환 | squamous cell carcinoma
|
C0007137
Squamous cell carcinoma
|
scispacy | 1 | |
| 질환 | bleeding
|
C0019080
Hemorrhage
|
scispacy | 1 | |
| 질환 | fistula
|
C0016169
pathologic fistula
|
scispacy | 1 | |
| 질환 | hemorrhage
|
C0019080
Hemorrhage
|
scispacy | 1 | |
| 기타 | mandibular
|
scispacy | 1 | ||
| 기타 | arterial
|
scispacy | 1 | ||
| 기타 | man
|
scispacy | 1 | ||
| 기타 | anterior arch
|
scispacy | 1 | ||
| 기타 | iliac crest bone graft
|
scispacy | 1 | ||
| 기타 | periosteum
|
scispacy | 1 | ||
| 기타 | venous pedicle
|
scispacy | 1 | ||
| 기타 | bone graft
|
scispacy | 1 | ||
| 기타 | vascular
|
scispacy | 1 |
MeSH Terms
Aged; Anastomosis, Surgical; Arteries; Bone Transplantation; Carcinoma, Squamous Cell; Emergencies; Humans; Ligation; Male; Mandible; Mandibular Neoplasms; Mouth Neoplasms; Surgery, Plastic
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