Prelaminated free flap for the reconstruction of maxillary defects.
- Author:
Ji Youn KIM
1
;
Kang Mi PANG
;
Jong Chul PARK
;
Sung Min KIM
;
Hoon MYOUNG
;
Myung Jin KIM
;
Jong Ho LEE
Author Information
1. Department of Oral and Maxillofacial Surgery, Seoul National University, Korea. leejongh@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Prelaminated forearm flap;
Prelaminated scapular flap;
Maxillofacial reconstruction;
Maxillary defect
- MeSH:
Deglutition;
Epithelium;
Esthetics;
Follow-Up Studies;
Forearm;
Free Tissue Flaps;
Humans;
Mandible;
Mastication;
Maxilla;
Mouth;
Mouth Floor;
Porphyrins;
Sputum
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2009;35(1):13-20
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND In contrast to defects of the mandible and mouth floor region, in the defect of maxilla, the availability of firmly attached oral and nasal mucosal linings is needed. In addition to it, in consider of operation field, operating convenience, and esthetics, reconstruction using prelaminated flap is strongly recommended. Therefore we consider the prelaminated flap through the cases that is reconstructed using prelaminated forearm flap and prelaminated scapular flap. PATIENTS AND METHODS From 2001 to 2008, in OMFS SNUDH, there were 6 cases that had reconstruction using prelaminated forearm free flap and other 3 cases that had reconstruction using prelaminated scapular flap of maxilla. The average age of patients that were reconstructed using prelaminated forearm free flap was 47.5 years, the average prelaminated period (after 1st operation ~ until 2nd operation) was 51.8 days and the average follow-up period after 2nd operation was 35.3 months. As well, the average age of patients that were reconstructed using prelaminated scapular free flap was 37 years, the average prelaminated period (after 1st operation ~ until 2nd operation) was 57 days and the average follow-up period after 2nd operation was 42.3 months. RESULTS Except 1 case that were reconstructed using prelaminated scapular flap, we could get firmly attached oral and nasal stable skin(mucosal like) lining, more adequate thickness flap than any other flap and improved esthetic and functional results in the other 8 cases that were reconstructed using prelaminated flap. The complications of the prelaminated forearm flap cases were inconvenient swallowing, sputum, limitation of mouth opening and difficult mastication. It came from flap shrinkage of the flap in some aspect, as well as other combined operations such as mass resection or RND. The difficult point of the reconstruction of prelaminated scapular flap was the possibility of vascular damage at preparation of flap in 2nd surgery. The damage could cause the failure of the prelaminated scapular flap. And the skin-lining of the prelaminated flap had limitations, so it is needed to study about the cultured oral epithelium-lining flap instead of the skin-lining flap. CONCLUSION We considered about advantages, complications and notable things of prelaminated flap through maxillary reconstruction cases using prelaminated forearm flap and prelaminated scapular flap so far. Furthermore, we should go on studying for functional reconstruction of prelaminated fasciomucosal flap using cultured oral epithelium.
