nach oben

Oral and Maxillofacial Surgery

Erschienen in:

01.09.2015 | Review Article

Distraction histogenesis of the maxillofacial region

verfasst von: Aydin Gülses, Metin Sencimen, Mustafa Ayna, Matthias Gierloff, Yahya Açil

Erschienen in: Oral and Maxillofacial Surgery | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

The changes in the surrounding soft tissues during long bone distraction in orthopedic surgery have been the subject of several reports, studies on changes in the craniofacial region, in which various tissues, including the skin, muscle, tendon, blood vessel, and gingiva are rare. Therefore, there is a need for studies on the soft tissue aspects of bone lengthening of the craniofacial region. The aim of this review was to address this issue by reviewing the literature about the distraction histogenesis of various tissues, including skin, muscle, blood vessel, nerve, and gingiva.

Apaydin A, Yazdirduyev B, Can T, Keklikoglu N (2011) Soft tissue changes during distraction osteogenesis. Int J Oral Maxillofac Surg 40(4):408–412CrossRefPubMed

Carlson DS, Ellis E III, Dechow PC (1987) Adaptation of the suprahyoid muscle complex to mandibular advancement surgery. Am J Orthod Dentofac Orthop 92:134–143CrossRef

Altug-Atac AT, Grayson BH, McCarthy JG (2008) Comparison of skeletal and soft-tissue changes following unilateral mandibular distraction osteogenesis. Plast Reconstr Surg 121:1751–1759PubMed

Codivilla A (1994) On the means of lengthening, in the lower limbs, the muscles and tissues which are shortened through deformity. Clin Orthop Relat Res 301:4–9PubMed

Enislidis G, Fock N, Millesi-Schobel G, Klug C, Wittwer G, Yerit K, Ewers R (2005) Analysis of complications following alveolar distraction osteogenesis and implant placement in the partially edentulous mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:25–30CrossRefPubMed

Altuğ HA, Aydintuğ YS, Şençimen M, Günhan O, Ortakoğlu K, Bayar GR, Doğan N (2011) Histomorphometric analysis of different latency periods effect on new bone obtained by periosteal distraction: an experimental study in the rabbit model. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(5):539–546CrossRefPubMed

Karacay S, Akin E, Okçu KM, Bengi AO, Altug HA (2005) Mandibular distraction with MD-DOS device. Angle Orthod 75:685–693PubMed

Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues: part II. The influence of the rate and frequency of distraction. Clin Orthop 239:263–285PubMed

Ilizarov GA (1992) The transosseous osteosynthesis: theoretical and clinical aspects of the regeneration and growth of tissue. Springer, New YorkCrossRef

10.

Peltomäki T (2009) Stability, adaptation and growth following distraction osteogenesis in the craniofacial region. Orthod Craniofacial Res 12:187–194CrossRef

11.

Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. Clin Orthop Relat Res 238:249–281PubMed

12.

Castaño FJ, Troulis MJ, Glowacki J, Kaban LB, Yates KE (2001) Proliferation of masseter myocytes after distraction osteogenesis of the porcine mandible. J Oral Maxillofac Surg 59:302–307CrossRefPubMed

13.

Molina F, Ortiz MF (1995) Mandibular elongation and remodeling by distraction: a farewell to major osteotomies. Plast Reconstr Surg 96:825–840CrossRefPubMed

14.

Sato M, Maruoka Y, Kunimori K, Imai H, Kabasawa Y, Ichinose S, Harada K, Omura K (2007) Morphological and immunohistochemical changes in muscle tissue in association with mandibular distraction osteogenesis. J Oral Maxillofac Surg 65:1517–1525CrossRefPubMed

15.

Carmichael KD, Maxwell SC, Calhoun JH (2005) Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation. J Pediatr Orthop 25:523–528CrossRefPubMed

16.

Bar-Meir E, Yaffe B, Winkler E, Sher N, Berenstein M, Schindler A (2006) Combined Iliazarov and free flap for severe recurrent flexion-contracture release. J Burn Care Res 27:529–534CrossRefPubMed

17.

Hiraki S, Nakamura I, Okazaki H, Nakamura K, Kurokawa T (2006) Skin behavior during leg lengthening in patients with achondroplasia and hypochondroplasia: a short-term observation during leg lengthening. J Orthop Sci 11:267–271CrossRefPubMed

18.

Saghieh S, El Bitar Y, Berjawi G, Harfouche B, Atiyeh B (2011) Distraction histogenesis in ankle burn deformities. J Burn Care Res 32:160–165CrossRefPubMed

19.

Chang H, Kwon ST, Chung CY, Choi IH, Ahn HT, Cho KH (2007) Changes in skin during distraction osteogenesis of the tibia in Sprague-Dawley rats: verification of epidermal proliferation by immunohistochemical methods. Scand J Plast Reconstr Surg Hand Surg 41:97–102CrossRefPubMed

20.

Rikimaru H, Kiyokawa K, Watanabe K, Koga N, Nishi Y (2010) A new therapeutic strategy for lengthening severe short nose. J Craniofac Surg 21:495–498CrossRefPubMed

21.

Elsalanty ME, Taher TN, Zakhary IE, Al-Shahaat OA, Refai M, El-Mekkawi HA (2007) Reconstruction of large mandibular bone and soft-tissue defect using bone transport distraction osteogenesis. J Craniofac Surg 18:1397–1402CrossRefPubMed

22.

Aronson J, Shen XC, Gao GG, Miller F, Quattlebaum T, Skinner RA, Badger TM, Lumpkin CK Jr (1997) Sustained proliferation accompanies distraction osteogenesis in the rat. J Orthop Res 15:563–569CrossRefPubMed

23.

Hu J, Zou S, Li J, Chen Y, Wang D, Gao Z (2003) Temporospatial expression of vascular endothelial growth factor and basic fibroblast growth factor during mandibular distraction osteogenesis. J Craniomaxillofac Surg 31:238–243CrossRefPubMed

24.

Nissen NN, Polverini PJ, Gamelli RL, DiPietro LA (1996) Basic fibroblast growth factor mediates angiogenic activity in early surgical wounds. Surgery 119(4):457–465CrossRefPubMed

25.

Nissen NN, Polverini PJ, Koch AE, Volin MV, Gamelli RL, DiPietro LA (1998) Vascular endothelial growth factor mediates angiogenic activity during the proliferative phase of wound healing. Am J Pathol 152(6):1445–1452PubMedCentralPubMed

26.

Aronson J (1994) Temporal and spatial increases in blood flow during distraction osteogenesis. Clin Orthop Relat Res 301:124–131PubMed

27.

Pacicca DM, Patel N, Lee C, Salisbury K, Lehmann W, Carvalho R, Gerstenfeld LC, Einhorn TA (2003) Expression of angiogenic factors during distraction osteogenesis. Bone 33:889–898CrossRefPubMed

28.

Rowe NM, Mehrara BJ, Luchs JS, Dudsziak ME, Steinbrech DS, Illei PB et al (1999) Angiogenesis during mandibular distraction. Ann Plast Surg 42:470–475CrossRefPubMed

29.

Lindeboom JA, Mathura KR, Milstein DM, Ince C (2008) Microvascular soft tissue changes in alveolar distraction osteogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:350–355CrossRefPubMed

30.

Glowacki J (1998) Angiogenesis in fracture repair. Clin Orthop Relat Res. (355 Suppl):S82-9

31.

Mosheiff R, Cordey J, Rahn BA, Perren SM, Stein H (1996) The vascular supply to bone in distraction osteogenesis: an experimental study. J Bone Joint Surg Br 78:497–498PubMed

32.

Warren SM, Mehrara BJ, Steinbrech DS, Paccione MF, Greenwald JA, Spector JA, Longaker MT (2001) Rat mandibular distraction osteogenesis: part III. Gradual distraction versus acute lengthening. Plast Recontr Surg 107:441–453CrossRef

33.

Byun JH, Park BW, Kim JR, Lee JH (2007) Expression of vascular endothelial growth factor and its receptors after mandibular distraction osteogenesis. Int J Oral Maxillofac Surg 36:338–344CrossRefPubMed

34.

Shevtsov VI, Gordievskikh NI, Bunov VS, Petrovskaya NV (2002) Changes in blood flow during tibial thickening by the Ilizarov method. Bull Exp Biol Med 134:525–527CrossRefPubMed

35.

Hansen-Algenstaedt N, Algenstaedt P, Böttcher A, Joscheck C, Schwarzloh B, Schaefer C et al (2003) Bilaterally increased VEGF levels in muscles during experimental unilateral callus distraction. J Orthop Res 21:805–812CrossRefPubMed

36.

Hausman MR, Schaffler MB, Majeska RJ (2001) Prevention of fracture healing in rats by an inhibitor of angiogenesis. Bone 29:560–564CrossRefPubMed

37.

Street J, Bao M, deGuzman L, Bunting S, Peale FV Jr, Ferrara N, Steinmetz H, Hoeffel J, Cleland JL, Daugherty A, van Bruggen N, Redmond HP, Carano RA, Filvaroff EH (2002) Vascular endothelial growth factor stimulates bone repair by promoting angiogenesis and bone turnover. Proc Natl Acad Sci U S A 99(15):9656–9661PubMedCentralCrossRefPubMed

38.

Fink B, Singer J, Braunstein S, Schwinger G, Schmielau G, Ruther W (1999) Behavior of blood vessels during lower-leg lengthening using Ilizarov method. J Pediatr Orthop 19:748–753PubMed

39.

Moore DC, Leblanc CW, Müller R, Crisco JJ, Ehrlich MG (2003) Physiologic weight-bearing increases new vessel formation during distraction osteogenesis: a micro-tomographic imaging study. J Orthop Res 21:489–496CrossRefPubMed

40.

Ganey TM, Klotch DW, Slater-Haase AS, Sasse J (1994) Evaluation of distraction osteogenesis by scanning electron microscopy. Otolaryngol Head Neck Surg 111:265–272CrossRefPubMed

41.

Ganey TM, Klotch DW, Sasse J, Ogden JA, Garcia T (1994) Basement membrane of blood vessels during distraction osteogenesis. Clin Orthop 301:132–138PubMed

42.

Kim MK, Kwon ST, Chang H, Minn KW, Cho TJ, Choi IH (2008) Distraction histogenesis of an anastomosed artery. Injury 39:719–724CrossRefPubMed

43.

Skoulis TG, Verkis MD, Terzis JK (1998) Effect of distraction osteogenesis on the peripheral nerve: experimental study in the rat. J Reconstr Microsurg 14:565–574CrossRefPubMed

44.

Makarov MR, Harper RP, Cope JB, Samchukov ML (1998) Evaluation of inferior alveolar nerve function during distraction osteogenesis in the dog. J Oral Maxillofac Surg 56:1417–1423CrossRefPubMed

45.

Michieli S, Miotti B (1977) Lengthening of mandibular body by gradual surgical-orthodontic distraction. J Oral Surg 35:187–192PubMed

46.

Klein C, Howaldt HP (1995) Lengthening of the hypoplastic mandible by gradual distraction in childhood: a preliminary report. J Craniomaxillofac Surg 23:68–74CrossRefPubMed

47.

Takato T, Harii K, Hirabayashi S, Komuro Y, Yonehara Y, Susami T (1993) Mandibular lengthening by gradual distraction: analysis using accurate skull replicas. Br J Plast Surg 46:686–693CrossRefPubMed

48.

Lee DY, Han TR, Choi IH, Lee CK, Chung SS (1992) Changes in somatosensory evoked potentials in limb lengthening: an experimental study on rabbits’ tibiae. Clin Orthop 285:273–279PubMed

49.

Makarov MR, Birch JG, Delgado MR, Welch RD, Samchukov ML (1996) Effects of external fixation and limb lengthening on peripheral nerve function. Clin Orthop 329:310–316CrossRefPubMed

50.

Karp NS, Thorne CH, McCarthy JG, Sissons HA (1990) Bone lengthening in the craniofacial skeleton. Ann Plast Surg 24:231–237CrossRefPubMed

51.

Wang XX, Wang X, Li ZL (2002) Effects of mandibular distraction osteogenesis on the inferior alveolar nerve: an experimental study in monkeys. Plast Reconstr Surg 109:2373–2383CrossRefPubMed

52.

Meyer M, Matsuoka I, Wetmore C, Olson L, Thoenen H (1992) (1992) Enhanced synthesis of brain derived neurotrophic factor in the lesioned peripheral nerve: different mechanisms are responsible for the regulation of BDNF and NGF mRNA. J Cell Biol 119:45–54CrossRefPubMed

53.

Anthony C, DiStefano PS (1998) Neurotrophin trafficking by anterograde transport. Trends Neurosci 21:433–437CrossRef

54.

Levi-Montalcini R (1987) The nerve growth factor 35 years later. Science 237:1154–1162CrossRefPubMed

55.

Hu J, Zou S, Tang Z, Wang D, Li J, Gao Z (2003) Response of Schwann cells in the inferior alveolar nerve to distraction osteogenesis: an ultrastructural and immunohistochemical study. Int J Oral Maxillofac Surg 32:318–324CrossRefPubMed

56.

Park BW, Kim JR, Lee JH, Byun JH (2006) Expression of nerve growth factor and vascular endothelial growth factor in the inferior alveolar nerve after distraction osteogenesis. Int J Oral Maxillofac Surg 35:624–630CrossRefPubMed

57.

Farhadieh RD, Nicklin S, Yu Y, Gianoutsos MP, Walsh WR (2003) The role of nerve growth factor and brain-derived neurotrophic factor in inferior alveolar nerve regeneration in distraction osteogenesis. J Craniofac Surg 14:859–865CrossRefPubMed

58.

Donato R (1991) Perspectives in S-100 protein biology. Review article. Cell Calcium 12:713–726CrossRefPubMed

59.

Frostick SP, Yin Q, Kemp GJ (1998) Schwann cells, neurotrophic factors, and peripheral nerve regeneration. Microsurgery 18:397–405CrossRefPubMed

60.

Hu J, Tang Z, Wang D, Buckley MJ (2000) Changes in the inferior alveolar nerve after mandibular lengthening with different rates of distraction. J Oral Maxillofac Surg 59:1041–1045CrossRef

61.

Rosenstein JM, Krum JM (2004) New roles for VEGF in nervous tissue—beyond blood vessels. Exp Neurol 187:246–253CrossRefPubMed

62.

Sondell M, Lundborg G, Kanje M (1999) Vascular endothelial growth factor has neurotrophic activity and stimulates axonal outgrowth, enhancing cell survival and Schwann cell proliferation in the peripheral nervous system. J Neurosci 19:5731–5740PubMed

63.

Wells L, Edwards KA, Bernstein SI (1996) Myosin heavy chain isoforms regulate muscle function but not myofibril assembly. EMBO J 15:4454–4459PubMedCentralPubMed

64.

Ianuzzo D, Patel P, Chen V, O’Brien P, Williams C (1977) Thyroidal trophic influence on skeletal muscle myosin. Nature 270(5632):74–76CrossRefPubMed

65.

Pette D, Vrbová G (1992) Adaptation of mammalian skeletal muscle fibers to chronic electrical stimulation. Rev Physiol Biochem Pharmacol 120:115–202CrossRefPubMed

66.

Komi PV, Viitasalo JH, Havu M, Thorstensson A, Sjödin B, Karlsson J (1977) Skeletal muscle fibres and muscle enzyme activities in monozygous and dizygous twins of both sexes. Acta Physiol Scand 100:385–392PubMed

67.

Nakamura T, Masui S, Wada M, Katoh H, Mikami H, Katsuta S (1993) Heredity of muscle fibre composition estimated from a selection experiment in rats. Eur J Appl Physiol Occup Physiol 66:85–89CrossRefPubMed

68.

Suwa M, Nakamura T, Katsuta S (1996) Heredity of muscle fiber composition and correlated response of the synergistic muscle in rats. Am J Physiol 27:R432–R436

69.

Nimmo MA, Wilson RH, Snow DH (1985) The inheritance of skeletal muscle fibre composition in mice. Comp Biochem Physiol A Comp Physiol 81:109–115CrossRefPubMed

70.

Ilizarov GA (1990) Clinical application at the tension-stress effect for limb lengthening. Clin Orthop 250:8–17PubMed

71.

Ilizarov GA, Ledyaev VI (1992) The replacement of tubular bone defects by lengthening distraction osteotomy of the fragments. Clin Orthop 280:7–14PubMed

72.

Fisher E, Staffenberg DA, McCarthy JG, Miller DC, Zeng J (1997) Histopathologic and biochemical changes in the muscles affected by distraction osteogenesis of the mandible. Plast Reconstr Surg 99:366–371CrossRefPubMed

73.

Simpson AH, Williams PE, Kyberd P, Goldspink G, Kenwright J (1995) The response of muscle to leg lengthening. J Bone Joint Surg Br 77:630–636PubMed

74.

Ellis E 3rd, Carlson DS (1983) Stability two years after mandibular advancement with and without suprahyoid myotomy: an experimental study. J Oral Maxillofac Surg 41:426–437CrossRefPubMed

75.

Troulis MJ, Glowacki J, Perrott DH, Kaban LB (2000) Effects of latency and rate on bone formation in a porcine mandibular distraction model. J Oral Maxillofac Surg 58:507–513, discussion 514CrossRefPubMed

76.

Kruse-Lösler B, Flören C, Stratmann U, Joos U, Meyer U (2005) Histologic, histomorphometric and immunohistologic changes of the gingival tissues immediately following mandibular osteodistraction. J Clin Periodontol 32:98–103CrossRefPubMed

77.

Cope JB, Samchukov ML (2000) Regenerate bone formation and remodeling during mandibular osteodistraction. Angle Orthod 70:99–111PubMed

78.

Chin M, Toth BA (1996) Distraction osteogenesis in maxillofacial surgery using internal devices: review of five cases. J Oral Maxillofac Surg 54:45–54CrossRefPubMed

79.

Ortakoglu K, Suer BT, Ozyigit A, Ozen T, Sencimen M (2006) Vertical distraction osteogenesis of fibula transplant for mandibular reconstruction: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:e8–e11CrossRefPubMed

80.

Shevtsov VI, Asonova SN, Yerofeyev SA (1995) Morphological characteristics of angiogenesis in the myofascial tissues of a limb elongated by the Ilizarov method. Bull Hosp Jt Dis 54:76–84PubMed

81.

Makarov MR, Kochutina LN, Samchukov ML, Birch JG, Welch RD (2001) Effect of rhythm and level of distraction on muscle structure: an animal study. Clin Orthop Relat Res 384:250–264CrossRefPubMed

82.

Ten Cate AR (1998) Repair and regeneration of dental tissues. In: Ten Cate AR (ed) Oral histology: development, structure, and function. Mosby, St Louis, pp 408–423

83.

Cope JB, Samchukov ML, Muirhead DE (2002) Distraction osteogenesis and histogenesis in beagle dogs: the effect of gradual mandibular osteodistraction on bone and gingiva. J Periodontol 73:271–282CrossRefPubMed

84.

Kunimori K, Maruoka Y, Sato M, Harada K, Omura K (2007) The effect of mandibular distraction osteogenesis on the histology and immunohistology of keratinized gingiva. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:738–744CrossRefPubMed

85.

Okcu KM, Sencimen M, Karacay S, Bengi AO, Ors F, Dogan N, Gokce HS (2009) Anterior segmental distraction of the hypoplastic maxilla by a tooth borne device: a study on the movement of the segment. Int J Oral Maxillofac Surg 38:817–822CrossRefPubMed

86.

Sencimen M, Aydintug YS, Ortakoglu K, Karslioglu Y, Gunhan O, Gunaydin Y (2007) Histomorphometrical analysis of new bone obtained by distraction osteogenesis and osteogenesis by periosteal distraction in rabbits. Int J Oral Maxillofac Surg 36:235–242CrossRefPubMed

87.

Carroll NC, Grant CG, Hudson R, Gilbert J, Mubarak SJ, Warren R (1981) Experimental observations on the effects of leg lengthening by theWagner method. Clin Orthop Relat Res 7:250–257

88.

Chin M, Toth BA (1997) LeFort III advancement with gradual distraction using internal devices. Plast Reconstr Surg 100:819–830CrossRefPubMed

89.

Choi IH, Ahn JH, Chung CY, Cho TJ (2000) Vascular proliferation and blood supply during distraction osteogenesis: a scanning electron microscopic observation. J Orthop Res 18:698–705CrossRefPubMed

Titel: Distraction histogenesis of the maxillofacial region
verfasst von: Aydin Gülses
Metin Sencimen
Mustafa Ayna
Matthias Gierloff
Yahya Açil
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Oral and Maxillofacial Surgery / Ausgabe 3/2015
Print ISSN: 1865-1550
Elektronische ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-015-0495-4

Neu im Fachgebiet Chirurgie

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Wie sieht der OP der Zukunft aus?

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Recycling im OP – möglich, aber teuer

02.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO₂-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2015

HSP70 expression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma

Erratum to: Autologous blood injection for treatment of chronic recurrent TMJ dislocation: is it successful? Is it safe enough? A systematic review

Comparison of intraoperative time measurements between osseous reconstructions with free fibula flaps applying computer-aided designed/computer-aided manufactured and conventional techniques

Evaluation of the rigidity of sagittal split ramus osteotomy fixation using four designs of biodegradable and titanium plates—a numerical study

Reduced somatosensory impairment by piezosurgery during orthognathic surgery of the mandible

Removal of migrated dental implants from maxillary sinus 4 years 10 months after implant placement

Update Chirurgie