Rekonštrukcia čela a čelovej dutiny sa robila pri úrazoch, zápaloch a nádoroch v tejto oblasti. Sledovaný súbor tvorí 19 pacientov liečených v rokoch 1996 až 2001 pre úraz čela (12), nádor (6) a zápal (1) v čelovej dutine. Na rekonštrukciu kostenej steny dutiny sa použili titanové minidlahy (6krát), kostný štep z lopaty panvovej kosti (3krát), chrupka z rebra (1krát), alebo sa kostné úlomky fixovali silonovým stehom (6krát). Pre obliteráciu čelovej dutiny sme sa rozhodli len v prípade ak sa rekonštrukcia nedala urobiť (4krát). V prípade frontobazálneho poranenia s poškodením zadnej steny a mozgových obalov je potrebná spolupráca s neurochirurgom. Revízia vývodu čelovej dutiny je nevyhnutnou súčasťou operácie.

Reconstruction of the forehead and frontal cavity is necessary in case of injury, tumour and chronic inflammation in this region. From 1996 to 2001 19 patients were operated on for frontal fracture (12) tumour (6) and frontal sinusitis (1). The postoperative bone defect was reconstructed in all cases. Several approaches were used. In the case of injury with torn skin the operative field was reached through the wound. Eyebrow incision was used in 7 cases, eyebrow incision with skin incision in nasal root in 5 cases, and coronal incision with scalp stripping was used in 5 cases where wide frontal exposure was desired. Impression fracture of the frontal bone was managed either by elevation and fixation of bony fragments using permanent suture material or metal splints. Initially a bony graft from the iliac crest, or rib cartilage was used for reconstruction of a large bony defect, now metal titanium minisplints and mesh are used instead. In three cases the anterior frontal wall was destroyed by big osteoma and there was no healthy bone suitable for reconstruction. On patient suffered from hyperostosis, which had to be removed. Aesthetic results were very good in all but one patient and a second operation because of sinusitis was required in two patients. In patients with frontobasal fractures with liquorrhea and a damaged posterior wall cooperation with a neurosurgeon is neccessary. Peroperative revision of the frontonasal duct is recommended.

Klinika ORL LF Univ Kom FN a SPAM Bratislava

Reconstruction of the forehead and frontal cavity

Rekonštrukcia čela a čelovej dutiny = Reconstruction of the forehead and frontal cavity /

Lit: 5

Souhrn: eng