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严重的颅面外伤累及额窦时,医生面临的主要难题是额骨重建。通常医生顾虑创面污染可能造成脑膜炎或脑脓肿,从而导致重建手术的失败,以及由于做重建手术延长麻醉时间而对病人的康复不利。因此一般情况下多采取清除碎骨片,切除额窦,择机再行二期重建手术。作者则应用游离自体骨和软组织瓣行一期额骨再植,处理严重的粉碎性骨折,取得良好效果。具体手术操作如下:清除创面上的细小碎骨片,刮除碎骨片粘膜,磨除额窦内壁的骨皮质。从额窦上方取一块颅骨外板做为修复额骨缺损的主体,用2mm薄的钛合金板和螺丝钉将可利用的碎骨片和再植用的颅骨外板相连
When a serious craniofacial trauma involves the frontal sinus, the major problem doctors face is frontal reconstruction. It is common for doctors to consider that wound contamination may cause meningitis or brain abscess, resulting in failure of reconstructive surgery and adverse patient rehabilitation due to prolonged anesthesia during reconstructive surgery. Therefore, under normal circumstances to take more to remove bone fragments, removal of the frontal sinus, select the second phase of reconstructive surgery. The author applied free autologous bone and soft tissue flap replantation of a frontal bone, the treatment of severe comminuted fracture, and achieved good results. Specific surgical operations are as follows: remove the wound on the bone fragments, scraping bone fragments of mucosa, ablating the frontal sinus wall cortex. From the top of the frontal sinus to take a piece of the outer skull as a frontal defect repair the body, with 2mm thin titanium plate and screw the available pieces of bone fragments and replantation of skull outer plate connected