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Full Facial Allotransplantation Including the Temporomandibular Joints: A Radiologic and Anatomical Cadaveric Study.
Nunez-Villaveiran, Teresa; Fahradyan, Vahe; Dalla Pozza, Edoardo; Rezaei, Majid; Drake, Richard L; Jellema, Lyman M; García-de-Lorenzo, Abelardo; Papay, Frank A; Bassiri Gharb, Bahar; Rampazzo, Antonio.
Afiliação
  • Nunez-Villaveiran T; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Fahradyan V; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Dalla Pozza E; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Rezaei M; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Drake RL; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Jellema LM; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • García-de-Lorenzo A; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Papay FA; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Bassiri Gharb B; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
  • Rampazzo A; From the Department of Plastic Surgery, Cleveland Clinic; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Physical Anthropology Laboratory, Cleveland Museum of Natural History; and the Department of Intensive Care, University Hospital "La Paz."
Plast Reconstr Surg ; 146(3): 622-632, 2020 09.
Article em En | MEDLINE | ID: mdl-32459733
BACKGROUND: Facial allotransplantation including the temporomandibular joints may improve the functional outcomes in face transplant candidates who have lost or damaged this joint. METHODS: Linear and angular measurements were taken in 100 dry skulls and mandibles and in 100 three-dimensionally-reconstructed facial computed tomographic scans to determine the variability of the temporomandibular joint, glenoid fossa, and mandible. A vascular study was performed in six fresh cadaveric heads, followed by harvest of the face allograft in three heads. Next, four heads were used for mock transplantation (two donors and two recipients). The full facial allograft included four different segments: a Le Fort III, a mandibular tooth-bearing, and two condyle and temporomandibular joint-bearing segments. Statistical analysis was performed using SAS software. RESULTS: In only one-third of the skulls, the condylar shape was symmetric between right and left sides. There was a wide variability in the condylar coronal (range, 14.3 to 23.62 mm) and sagittal dimensions (range, 5.64 to 10.96 mm), medial intercondylar distance (range, 66.55 to 89.91 mm), and intercondylar angles (range, 85.27 to 166.94 degrees). This high variability persisted after stratification by sex, ethnicity, and age. The temporomandibular joint was harvested based on the branches of the superficial temporal and maxillary arteries. The design of the allograft allowed fixation of the two condyle and temporomandibular joint-bearing segments to the recipient skull base, preserving the articular disk-condyle-fossa relationship, and differences were adjusted at the bilateral sagittal split osteotomy sites. CONCLUSION: Procurement and transplantation of a temporomandibular joint-containing total face allograft is technically feasible in a cadaveric model.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Osso Temporal / Articulação Temporomandibular / Osteotomia de Le Fort / Transplante de Face / Mandíbula Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Osso Temporal / Articulação Temporomandibular / Osteotomia de Le Fort / Transplante de Face / Mandíbula Idioma: En Ano de publicação: 2020 Tipo de documento: Article