Most plastic surgery articles portray problems that plastic surgeons can treat effectively. They rarely show the even more striking problems which cannot be dealt with. The patient who has been cured of his oral cancer, but who is left with a major facial defect may have won a battle for life, only to be condemned to a """"""""social death"""""""", because of the inadequacy of current techniques of reconstructive surgery. Major congenital and traumatic defects can be similarly defeating. If allografts of composite craniofacial tissue could be successfu ly transplanted as replacement modules for deformed craniofacial structures, we would have an effective clinical tool. We have showed that the new drug, cyclosporine, prolongs the survival of allografted hind limbs in rats (Lewis Brown Norway to Lewis) combination, a strong histocompatibility barrier). We obtained indefinite survival (over 500 days) without signs of drug toxicity. We recently transplanted a """"""""module"""""""" of ear-scalp-calavarium from a Dutch rabbit to a New Zealand rabbit (3 months of age). The module is still alive and increasing in size at a near normal rate of growth 8 weeks postoperatively. We have showed the surgical feasibility of transplanting a mandibular allograft module in a similar rabbit model. We plan to transplant craniofacial allograft modules (ear-calavarium, maxilla-nose, mandible) in rabbits, pigs, and monkeys. We will follow survival, function and growth in these modules and in controls. Tantalum skeletal implants will be placed for special radiographic and celphalmetric studies. We will also develop potential surgical techniques in human cadavers.
| Randzio, J; Kniha, H; Gold, M E et al. (1991) Growth of vascularized composite mandibular allografts in young rabbits. Ann Plast Surg 26:140-8 |
| Kniha, H; Randzio, J; Gold, M E et al. (1989) Growth of forelimb allografts in young rabbits immunosuppressed with cyclosporine. Ann Plast Surg 22:135-41 |
