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Brazilian Journal of Craniomaxillofacial Surgery
Revista Oficial da Associação Brasileira de Cirurgia Crânio-maxilo-facial.

 Volume 3
Number 1   June 2000
 
TÍTULO
EVALUATION OF CRANIAL GROWTH IN RABBITS SUBMITTED TO CRANIOPLASTY WITH MEDULLARY BONE GRAFT, WITH AND
WITHOUT GROWTH FACTOR
AUTOR
Telma Cristiane Rodrigues Silva1; Margarete da Silva Augusto'; Aristides Augusto Palhares Neto, MD, PhDZ; Sílvio Antonio Zanin, MD3
 
The treatment of children with calvarial bone loss using procedures that do not interfere with growth has received significantaitention. The use of medullaybone graff taken from the iliac crest, associated with aplatelet-rich plasma concentration. has been shown to induce the formation of compact bone. Howeve,: there have been no studies about the growth paitem of bones submitted to this treatment. This workaims to evaluate the effect of this technique on cranialgrowth in rabbits. The sample was constitutedof40 6-weekoldNewZealandrabbits, weighing 1,1124grams, on average. The rabbits were dividedinto fivegroups, which were submiítedto cephalomety andcraniomety. ln the
present study, a11 the rabbits receiving a medullary bone graff presented good-quality bone at the moment of the sacrifice. Cephalomety and craniometry were used to evaluate cranial growth. Our results showed that medullary bone graffs, with or withoutplatelet-rich plasma, didnot interfere with cranialgrowfh.
KEY WORDS
Skull/GD: bone marrow transplantation: child; animals, laborafory; rabbits.
TÍTULO
MANDIBULAR DISTRACTION: COMPARISON BETWEEN INTRAORAL
AND EXTRAORAL DEVICES
AUTOR
Nivaldo Alonso, MD, PhD'; Renato da Silva Freitas, PhDZ
  Distraction osteogenesis (DO) is a method forbone lengthening that was popularized by llizarovin 1989. Do has been increasingly used in craniofacial surgery since McCarthy showed the clinical feasibility of lengthening hypoplastic mandibles, in 1992. Although the technique for DO seems to be simple, its performance is not.
Nonetheless, few reports about the use of extraoral or intraoral devices and associated advantages, disadvantages and complications have been developed so far. In the present study, we report our experience
with DO in 65 cases of craniofacial microsomia, three cases of Treacher-Collins, and three cases of temporomandibular ankylosis. Fifty-four patients used extraoral devices, and 17 used intraoral devices. The
decision on which device to use was made according to the anatomical characteristics of eachpatient. Patients who required only unidirectional lengthening and had adequate mandibular bone stock were ideal candidates for intraoral distraction devices. Patients presenting with severe mandibular deficiencies who demanded multldirectional distraction were considered to be more adequately treated with an extraoral device. In generd the extraoral device is known to allow for a more efficient lengthening vector than the intraoral device; in our study, such problem was not obsewed. We managedto adequatelyposition the distradois m&nxb Guerrero's device.
KEY WORDS
Osteogenesis, distraction, mandible, surgery
TÍTULO
GALEAL FLAP IN CRANIOMAXILLOFACIAL RECONSTRUCTION
AUTOR
Marcus Vinicius Martins Collares, MD, PhD1; Rinaldo De Angeli Pinto, MD2; Nelson Pires Ferreira, MD3; Marcelo Paglioll Ferreira, MD4
  The correction of soft tissues in craniofacial deformities is currently being pehrmed with fat grafts, dennis fat grafts, microsurgical flaps, and aponeurotic galeal flaps. The present study aimed at discussing the use of galeal flaps and its clinical use and purpose, vascular pedicle and surgical approach, as well as possible host sites. Complications were also analyzed. Data were collected from a retrospective review of clinical records of patients operated from 1991 to 2001. A total of 346patients had383 galeal flaps raisedduring the studyperiod.
Galeal flaps were successfully used in reconstruction in a large number of pathologies. lhe most frequent surgical approach was coronal incision. Galeal flaps were used in almost every craniofacial region based on four different vascularpedicles. In terms ofpurpose, flaps were used to cover underlying tissues orbone graffs; to isolate cavities; and to add volume. Complications occurred in 16 flaps (4.18%) and included infection, necrosis, and hematoma. Concerning 171 flaps used for volume comection, resorption occurred in 7.6% of cases, leading to insufficient results in 6.43%. Positive aspects of the use of galeal flaps are their versatiliv, proximity to host site, rapidbone revascularization andsmall rate of complications. Associatednegative aspects include volume limitation and difiicultyin pedoming dissection. Galealflaps revealed to be an impoflant therapeutic option for reconstruction in craniomaxilofacial pathologies.
KEY WORDS
Surgical flap; deformities; retrospective study; surge
TÍTULO
COMPLICATIONS INVOLVED IN FACIAL TRAUMA SURGERY
AUTOR
Ricardo Lopes da Cruz, MD, TCBC'; Clarissa Leite Tiirrer, MD, ACBCZ
  In this review, we describe the main complications associated with mandibular fractures andmidface traumas.
As for mandibular fractures, we discuss complications which arise immediately after trauma and during the surgical treatment, in addition to those related to rigid fixation, condylar fractures, andlate complications. As for midface traumas, we discuss complications which arise immediately after trauma, those related to soft tissue, as well as skeletal complications
KEY WORDS
Mandibular fractures; surgery; review literature.
TÍTULO
CRANIOFACIAL ONCOLOGICAL SURGERY:AESTHETIC USE OF FLAPS AND GRAFTS
AUTOR
Athos Greco Jr., MD, DDS'; Leandro Fuchs, MD2; Wellington Gemelli dos Santos
  A signirkant number of reconstructive surgeries is performed for the treatment of skin and lip carcinomas. The present study aims at analyzing epidemiological aspects and the surgical management involved in those cases. The authors retrospectively review the medical records of patients presenting with tumors in the cranioffacid area, admitted to the Sewice ofPlasb Surgeryat Hospital Emesto Domelles, Brazil, andsubmitted to reconstrucfiVe surgeries with flaps andgrah from November 2000 to November 2002. Twelve cases were reviewed, among which 10 (83.3%) were male. Age ranged from 56 to 94 years (mean of 76.5). Being aware of epidemiological features inherent to skin and lip carcinomas is crucial for the understanding of their impact and of the way they manifest themselves in our context.
KEY WORDS
Medical oncology; carcinoma, basal cell; carcinoma, squamous cell; surgery