Primary Reconstruction After Maxillectomy Defects Using Ultra Flex Mesh Plate and Rectus Abdominis Myocutaneous Free Flap Including Aponeurosis of External Abdominal Oblique Muscle
| Autor: | Kiyoshi Onishi, Akihiro Ogino, Miho Nakamichi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Maxillary sinus Rectus Abdominis Free flap Free Tissue Flaps 03 medical and health sciences 0302 clinical medicine Bone plate Maxilla medicine Humans Aponeurosis 030223 otorhinolaryngology Aged Maxillary Neoplasms business.industry Oblique case Abdominal Oblique Muscles 030206 dentistry General Medicine Plastic Surgery Procedures Surgical Mesh Surgery Surgical mesh medicine.anatomical_structure Normal bone Otorhinolaryngology Hard palate business Bone Plates |
| Zdroj: | Journal of Craniofacial Surgery. 30:211-213 |
| ISSN: | 1049-2275 |
| DOI: | 10.1097/scs.0000000000005045 |
| Popis: | Background In primary reconstruction after maxillectomy for cancer, simple and less invasive surgical techniques considering functionality and aesthetics are necessary. The authors performed reconstruction for tissue defects after maxillectomy using an Ultra flex mesh plate and a free rectus abdominis myocutaneous flap including the aponeurosis of the external abdominal oblique muscle. Method A 72-year-old male with a maxillary squamous cell carcinoma underwent subtotal maxillectomy. For maxillary defects, including those in the orbital floor and hard palate, the authors performed rigid reconstruction using an Ultra flex mesh plate produced after simulation surgery using a 3-dimensional solid model, and palatal and soft tissue reconstruction using a free rectus abdominis myocutaneous flap including the aponeurosis of the external abdominal oblique muscle. After screw fixation of the mesh plate at the surrounding normal bone, the skinpaddle of the rectus abdominis flap was transferred to the oral defect. The surface of the mesh plate was completely covered with the aponeurosis of the external abdominal oblique muscle, and the remaining rectus abdominis flap was inserted into the maxillary sinus. Results At present, 1 year after the operation, there is no recurrence, complications, such as infection, or titanium mesh breakage/exposure, and his facial shape is favorably maintained. Conclusion Reconstruction using this method is simple and less invasive. Postoperative infection and plate exposure were prevented by the complete coverage of the mesh plate with the aponeurosis of the external abdominal oblique muscle and flap. Mesh plates, when properly used, are useful reconstruction materials, but are susceptible to infection compared with autologous tissue, requiring long-term follow-up. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|