| Co-Investigator(Kenkyū-buntansha) |
TANAKA Shinsuke Kurume University School of Medicine, Lecturer, 医学部, 助手 (70289495)
YANAGA Hiroko Kurume University School of Medicine, Assistant Professor, 医学部, 講師 (70217107)
TAI Yoshiaki Kurume University School of Medicine, Professor, 医学部, 教授 (20081789)
早川 宏司 久留米大学, 医学部, 助手 (00228553)
|
|---|
| Budget Amount *help |
¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2000: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1999: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1998: ¥600,000 (Direct Cost: ¥600,000)
|
|---|
| Research Abstract |
Reconstruction of the mandible and oral cavity is quite important after surgical treatment for malignant tumor. For this purpose, bone graft with vascular pedicle, skin flap, and/or muscle flap are utilized, but they are associated with significantly large invasion and long surgery time. In order to solve these problems, we examined applicability of regenerative medicine, and applied the findings to 2 patients. In the experiment using white rabbits, unilateral femur was surgically resected, cortex bone after removing bone marrow was boiled in 100℃ physiological saline for 30 min or longer, then bone marrow was returned into the cortex bone, it was divided into 2 pieces, and grafted subcutaneously or intramuscularly on the back. One month later, the rabbits were sacrificed, the grafted bone was resected, and examined radiographically, with CT, and histologically. As a result, significantly better bone regeneration was observed in the bone grafted in the muscle. This showed the mandible can be regenerated at the resected area by using heat-treated cortical bone(mandible), iliac cancellous bone(bone marrow)and a muscle flap. This knowledge was clinically applied to 2 patients who had recurrent oral cancer. The resected mandible was separated from the other tissues, bone marrow was removed, and the cortical bone was boiled after making many small holes. This heat-treated bone was fixed on the area of oral defect by using a titanium plate, iliac cancellous bone was grafted into the lumen, and the entire surrounding area was covered with the muscle flap made from the greater pectoral muscle. The skin island of the flap was used for the reconstruction of oral cavity. The 2 patients have good clinical outcomes, regained almost normal shape of the mandible, and there were no postoperative complications. Regeneration of the mandible was confirmed with radiographs and bone scintigraphy.
|
