The clinical application of 3-dimensional CT angiography in the repair of mandibular defects with deep circumflex iliac arterial flap
10.3760/cma.j.cn114453-20200419-00231
- VernacularTitle:三维CT血管造影在旋髂深动脉组织瓣修复下颌骨缺损中的临床应用
- Author:
Xiaoliang LI
1
;
Shengkai LIAO
;
Yongfeng CHEN
;
Zhaojun ZHAN
;
Xiao HONG
;
Xiaoying DU
;
Songtao YU
;
Linya GENG
Author Information
1. 蚌埠医学院第一附属医院口腔科 233004
- Keywords:
Deep circumflex iliac artery;
CT angiography;
Imaging, three-dimensional;
Mandibular defect
- From:
Chinese Journal of Plastic Surgery
2021;37(5):495-500
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical application of 3-dimensional CT angiography(3D-CTA) in the repair of mandibular defects with deep circumflex iliac arterial flaps.Methods:From January 2019 to January 2020, 5 patients with postoperative defects of mandibular tumors were treated in the Department of Stomatology of the First Affiliated Hospital of Bengbu Medical College, including 2 males and 3 females. The ages of the patients ranged from 30 to 70 years, with an average of 52 years. CT angiography of both lower limbs was performed before operation. Data were processed using the CT workstation. According to the size and shape of the defect in the recipient site, the 3D model of the deep circumflex iliac arterial flap(DCIA) was constructed. the contour of the DCIA was observed and measured, and the data was recorded, including the diameter of the vassel at the starting point, the angle between the line from the starting point to the anterior superior iliac spine and the line between the bilateral anterior superior iliac spine, and the distance from the starting point to the anterior superior iliac spine. According to the 3D model, a composite tissue flap pedicled with DCIA was designed and prepared for mandibular defect repair. The actual situation during the procedure was compared with the preoperative 3D model simultaneously.Results:The diameter of the DCIA at the starting point was (2.30±0.24) mm. The angle between the line from the starting point to the anterior superior iliac spine and the line between the bilateral anterior superior iliac spine was 39.3°±6.1°, and the distance from the starting point to the anterior superior iliac spine was (5.83±0.24) cm. The shape and position of the DCIA were basically consistent with the three-dimensional model. All the flaps survived well after operation. All the patients were followed up for 3 to 6 months, the bilateral maxillofacial region were basically symmetrical. The postoperative imaging examination showed that the iliac osteocutaneous flap healed well, and the height and width of mandibular alveolar ridge were restored satisfactorily. There were no complications such as numbness in the donor site, abdominal hernia and gait abnormality.Conclusions:The 3D model of the DCIA produced by 3D-CTA can accurately locate the position and route of the vessel, clearly display the three-dimensional spatial relationship between the skin, muscles and bones around the target blood vessel, and significantly reduce the complications and operative time.
