Surgical management of maxillectomy defects based on the concept of buttress reconstruction
- 5 January 2004
- journal article
- research article
- Published by Wiley in Head & Neck
- Vol. 26 (3), 247-256
- https://doi.org/10.1002/hed.10366
Abstract
Background. Few published large series have described a surgical approach to maxillary skeletal reconstruction on the basis of the extent of maxillectomy. Methods. We have reviewed a 10‐year experience with 38 consecutive maxillary reconstructions with respect to maxillectomy defects, reconstructive procedures, reconstructed buttresses, and functional and aesthetic outcomes. Results. Maxillectomy defects were classified into three categories on the basis of the buttress concept. Buttress reconstruction was most frequently performed in category III maxillary defects (56%), followed by category I (50%) and category II (20%). The vascularized composite autograft included the rectus abdominis myocutaneous free flap combined with costal cartilage, and the latissimus dorsi myocutaneous free flap combined with the V‐shaped scapula is an effective method for reliable reconstruction of both skeletal and soft tissues. Conclusions. A critical assessment for skeletal defects and associated soft tissue defects is essential for an adequate approach to solve complex problems in maxillary reconstruction. On the basis of retrospective analysis of this series, a reconstructive algorithm for surgical management of maxillectomy defects is proposed. © 2004 Wiley Periodicals, Inc. Head Neck 26: 247–256, 2004Keywords
This publication has 25 references indexed in Scilit:
- Role of Buttress Reconstruction in Zygomaticomaxillary Skeletal DefectsPlastic and Reconstructive Surgery, 1998
- Maxillectomy and its classificationHead & Neck, 1997
- An Anatomic Study of the Latissimus DorsiRib Flap: An Extension of the Subscapular Combined FlapPlastic and Reconstructive Surgery, 1996
- Reconstruction of a Complex Midfacial Defect with the Folded Fibular Free Flap and Osseointegrated ImplantsAnnals of Plastic Surgery, 1996
- Three-Dimensional Folded Free-Flap Reconstruction of Complex Facial Defects Using Intraoperative ModelingPlastic and Reconstructive Surgery, 1994
- The Bipedicled Osteocutaneous Scapula FlapPlastic and Reconstructive Surgery, 1991
- Reconstruction of complex maxillectomy defects with the scapular‐free flapHead & Neck, 1990
- Complex Maxillary FracturesPlastic and Reconstructive Surgery, 1986
- Vascularized Rib-Periosteal and Osteocutaneous Reconstruction of the Maxilla and MandiblePlastic and Reconstructive Surgery, 1980
- Structural Pillars of the Facial SkeletonPlastic and Reconstructive Surgery, 1980