gms | German Medical Science

43. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen e. V. (DGPRÄC), 17. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen e. V. (VDÄPC)

13.09. - 15.09.2012, Bremen

Ten-year Evolution Utilizing Computer-Assisted Reconstruction for Giant Ameloblastoma

Meeting Abstract

  • presenting/speaker P.N. Broer - NYU, Plastische Chirurgie, New York, United States
  • N. Tanna - NYU, Plastische Chirurgie, New York, United States
  • V. Thanik - NYU, Plastische Chirurgie, New York, United States
  • E. Garfein - NYU, Plastische Chirurgie, New York, United States
  • P. Saadeh - NYU, Plastische Chirurgie, New York, United States
  • D. Hirsch - NYU, Plastische Chirurgie, New York, United States
  • J. Levine - NYU, Plastische Chirurgie, New York, United States

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 43. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 17. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Bremen, 13.-15.09.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFV101

DOI: 10.3205/12dgpraec111, URN: urn:nbn:de:0183-12dgpraec1110

Veröffentlicht: 10. September 2012

© 2012 Broer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Various extirpative and reconstructive methods have been described for the treatment of large sized ameloblastomas. We describe our current practice of computer-aided virtual planned and pre-executed surgeries using microvascular free tissue transfer with immediate placement of implants and dental prosthetics.

Methods: All patients with ameloblastomas treated at NYU Medical Center during a 10-year period from September 2001 to December 2011 were identified. Of the 38 (36 mandible/2 maxilla) patients that were treated in this time period, 20 were identified with advanced disease (giant ameloblastoma) requiring aggressive resection. Reconstruction of the resultant defects utilized microvascular free tissue transfer with an osseo-cutaneous fibular flap in all 20 of these patients.

Results: Patients reconstructed with free vascularized tissue transfer suffered complications in 35% (7/20). These included neuropraxia, recipient site wound breakdown, and hematoma. There were two complete flap failures with consequent contra-lateral fibula flap placement. All patients ultimately healed their reconstructions well. Sixteen patients to date have undergone placement of endosteal implants for complete dental rehabilitation, nine of which received immediate placement of the implants at the time of the free flap reconstruction. The three most recent patients received immediate placement of dental implants at the time of microvascular free tissue transfer as well as concurrent placement of dental prosthesis, restoring full dental occlusion in one setting (Figure 1 [Fig. 1], Figure 2 [Fig. 2]).

Conclusions: To our knowledge, this patient cohort represents the largest series of comprehensive computer aided free-flap reconstruction with dental restoration for giant type ameoloblastoma.