A Comparison of Outcomes of Proximal and Distal Anastomosis Sites of the Facial Artery in Head and Neck Reconstruction

Abstract

Medication-related osteonecrosis of the jaw is a challenging condition of poorly understood etiology and pathogenesis, the management of which is complex. Each case should be managed on its individual context. Current literature notes a higher success rate in cases managed with aggressive surgical intervention, particularly in severe disease. This case does not refute this evidence, but does signify that conservative management may still be considered a valid treatment option, particularly in the elderly or medically compromised patient. Furthermore, the importance of multidisciplinary care is highlighted. The author notes that in this case conservative management was only initiated after a 2-stage surgical debridement and 6 months of antibiotics, in a situation where clinical improvement was apparent.

Reconstruction of the anterior maxillary defect using a vascularized bone flap with residual teeth in the posterior maxilla

“…A passage was made in the residual posterior maxilla, which allowed the vascular pedicle of the flap to pass from the palatal side to the buccal area (Figure 1C,D). Both supramandibular (anastomosis site above the inferior mandible border) 6 vascular and intraoral anastomosis were used (Figure 2). We chose this path when more than one tooth remained.…”