자가 머리뼈 이식 후 뼈결손부의 면적 변화

A Size Change of Bone Defect Area after Autogenous Calvarial Bone Graft

  • 현경배 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 김동석 (연세대학교 의과대학 신경외과학교실) ;
  • 유선국 (연세대학교 의과대학 의학공학교실) ;
  • 김희중 (연세대학교 의과대학 진단방사선과학교실) ;
  • 김용욱 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 박병윤 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실)
  • Hyun, Kyung Bae (Institute of Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Kim, Dong Suk (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Yoo, Sun Kook (Department of Medical Engineering, Yonsei University College of Medicine) ;
  • Kim, Hee Joung (Department of Diagnostic Radiology, Yonsei University College of Medicine) ;
  • Kim, Yong Oock (Institute of Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Park, Be-young Yun (Institute of Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
  • 투고 : 2005.03.09
  • 발행 : 2005.07.10

초록

Calvarial bone grafting in craniomaxillofacial trauma and facial reconstructive surgery is now widely recognized and accepted as a standard procedure. One of the commonly reported problems of calvarial bone graft is the contour defect caused by partial resorption of the graft. But, there are few reports that discuss the fate of the calvarial bone graft based on the quantitative data. In this article, the changes of grafted calvarial bone were evaluated using 3-dimensional computed tomography(CT). 9 patients were observed with the CT scans at 2mm thickness immediately after operation and at the time of last follow-up. The area of the bone defect was segmented on the 3-dimensional CT image and calculated by AnalyzeDirect 5.0 software. The immediate postoperative bone defect area of the recipient site and the donor site were $612.9mm^2$ and $441.5mm^2$, respectively, which became $1028.1mm^2$ and $268.8mm^2$, respectively at the last follow-up. In conclusion, the bone defect area was less increased on the donor site of calvarial bone graft than on the recipient site. And the CT scan is a valuable imaging method to assess and follow-up the clinical outcome of calvarial bone grafting.

키워드

과제정보

연구 과제 주관 기관 : 한국과학재단

참고문헌

  1. Powell NB, Riley RW: Cranial bone grafting in facial aesthetic and reconstructive contouring. Arch Otolaryngol Head Neck Surg 113: 713, 1987 https://doi.org/10.1001/archotol.1987.01860070027010
  2. Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V: Clinical outcome in cranioplasty: critical review in long-term follow-up. J Craniofac Surg 14: 144, 2003 https://doi.org/10.1097/00001665-200303000-00003
  3. Tessier P: Autogenous bone grafts taken from the calvarium for facial and cranial applications. Clin Plast Surg 9: 531, 1982
  4. Powell NB, Riley RW: Facial contouring with outer-table calvarial bone. A 4-year experience. Arch Otolaryngol Head Neck Surg 115: 1454, 1989 https://doi.org/10.1001/archotol.1989.01860360056017
  5. Gosain AK, Song L, Santoro TD, Amarante MT, Simmons DJ: Long-term remodeling of vascularized and nonvascularized onlay bone grafts: a macroscopic and microscopic analysis. Plast Reconstr Surg 103: 1443, 1999 https://doi.org/10.1097/00006534-199904050-00013
  6. Van der Meij AJW, Baart JA, Prahl-Andersen B, Valk J, Kostense PJ, Tuinzing DB: Computed tomography in evaluation of early secondary bone grafting. Int J Oral MaxilloJac Surg 23: 132, 1994 https://doi.org/10.1016/S0901-5027(05)80286-3
  7. Tai CC, Sutherland IS, McFadden L: Prospective analysis of secondary alveolar bone grafting using computed tomography. J Oral Maxillofac Surg 58: 1241, 2000 https://doi.org/10.1053/joms.2000.16623
  8. Dieleman FJ, Tump P, Baart JA, Tuinzing DB, Bezemer PD: A computed tomographic evaluation of change in bone volume after secondary bone grafting over the first postoperative year. Plast Reconstr Surg 114: 738, 2004 https://doi.org/10.1097/01.PRS.0000131019.95764.9F
  9. Jackson IT, Choi BY, Clay R, Bevilacqua R, TerKonda S, Celik M, Smith AW: Long-term follow-up of cranial bone graft in dorsal nasal augmentation. Plast Reconstr Surg 102: 1869, 1998 https://doi.org/10.1097/00006534-199811000-00010