Maxillary reconstruction using rectus femoris muscle flap and sagittal 
mandibular ramus/coronoid process graft pedicled with temporalis muscle

Wang, Weihong; Xu, Bin; Zhu, Jinzhou; Yang, Chen; Shen, Steve Guofang; Qian, Yun

doi:10.4317/medoral.22505

Cited by 6 publications

(3 citation statements)

References 26 publications

(28 reference statements)

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“…Although folded radial flaps have already been reported for palatal reconstruction (Kuroda et al, 2000; Rieger et al, 2008; Seikaly et al, 2008), we advocate placing the posterior border of the folded radial flap at the level of the anterior pillars (instead of closer to the posterior pharyngeal wall) to create two nasopharyngeal ports and thereby avoid nasal obstruction. Since the mucosalization process occurs fast in muscle tissue (Tsai et al, 2006; Wang et al, 2018), it is unnecessary to resurface the oral side of the superiorly based pharyngeal flap.…”

Section: Discussionmentioning

confidence: 99%

Speech and swallowing function following microsurgical reconstruction of palatal defects in a series of six pediatric patients

et al. 2022

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Background: Reconstruction of extensive palatal defects in growing patients aims to restore speech intelligibility and swallowing function while avoiding excessive scarring formation that may cause growth disturbances in the palate and midface region.Free flaps transfer healthy, well-vascularized tissue to the defect area, and their combination with pharyngeal flaps allow for restoration of the velopharyngeal function.We examined speech and swallowing after microsurgical palate reconstruction in a series of six pediatric patients.Methods: Radial forearm free flaps were used in all cases, in combination with a superiorly based pharyngeal flap in five cases. Mean age at surgery was 10.7 years. Etiologies included recurrent oronasal fistula due to failed primary cleft palate repair (n = 4), embryonal rhabdomyosarcoma of the maxilla (n = 1), and inflammatory fibrous hyperplasia (n = 1). Speech evaluations (with the Hirose standard and listener ratings) and swallowing assessments (based on videofluoroscopy swallowing studies and patientreported swallowing and diet) were performed in average 44 months postoperatively.Results: All flaps survived without major postoperative complications. Speech intelligibility was graded as "excellent" in four patients and "moderate" in two. Hypernasality and nasal obstruction were each judged as "none/minimal" in five cases and "moderate" in one case. All patients tolerated oral diet without significant nasal regurgitation. In five of six patients, the swallowing assessment showed good motion and velopharyngeal closure. Conclusion:Microsurgical reconstruction of extensive palatal defects using radial forearm free flap, with or without a superiorly based pharyngeal flap, is a reliable technique that can deliver substantial improvement of speech and swallowing in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Speech and swallowing function following microsurgical reconstruction of palatal defects in a series of six pediatric patients

et al. 2022

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“…The flaps were raised at the same time as the neck dissection and tumor resection by 2 surgical teams. The harvest of chimeric ALT and rectus femoris flaps was performed as previously presented 7,16 . The ALT flaps or its chimeric flaps were raised according to the need, and the whole rectus femoris muscle was harvested simultaneously (Fig.…”

Section: Methodsmentioning

confidence: 99%

Chimeric Anterolateral Thigh and Rectus Femoris Flaps for Reconstruction of Complex Oral and Maxillofacial Defects

Zhang

Liu

et al. 2020

Journal of Craniofacial Surgery

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Purpose: Complex oral and maxillofacial defects are continuously a challenge for reconstructive surgeons. This study evaluates the effects of chimeric anterolateral thigh (ALT) and rectus femoris flaps for the reconstruction of such defects. Patients and Methods: A retrospective review was performed of 10 patients who underwent reconstruction of oral and maxillofacial defects with chimeric ALT and rectus femoris flaps from October 2014 through August 2016 at the Second Xiangya Hospital. Results: All 10 patients were male, with a mean age of 53.6 years. Postoperatively, all flaps survived completely, without vascular compromise or major wound complications. Salivary fistula occurred in 1 patient, and wound effusion of the thigh occurred in another patient. Gradual wound healing was observed after repeated dressing changes. The patients were followed for approximately 3 to 46 months, the appearance and oral functions were recovered well, and no thigh motor dysfunctions were observed. Conclusions: Because of the convenient flap design, effective avoidance of recipient site complications, lower donor site morbidity, and acceptable functional and esthetic results, chimeric ALT and rectus femoris flaps are a good choice for the reconstruction of complex oral and maxillofacial defects.

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“…7 There were also many ways to reconstruct the maxillary, which include pedicled flaps such as temporal muscle flap, 8 free flaps including lateral femoral circumflex flap, 9 fibular flap, 10 composite flaps. 11,12 As the diverse pathological types and different range of lesions of the tumor, 2 as well as the difference regarding the patients’ physical conditions, economic status, requirements for quality of life. Prior to treatment, an individualized comprehensive treatment plan should be made by a multidisciplinary team (MDT).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Analysis of Individualized Treatments of Malignant Tumors Primary From Maxillary Sinus

et al. 2022

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Objectives To investigate the prognosis and quality of life for primary malignant maxillary sinus tumors. Methods This was a retrospective analysis. 164 patients diagnosed with primary malignant maxillary sinus tumors between 2005 and 2018 were recruited. Patients were treated according to the pathological type and the lesion range. Prognostic differences of different pathological types, surgical resection methods, repair methods, treatment methods, and different local recurrence sites were analyzed. Survival analysis and prognostic factors analysis were performed. Results Overall survival (OS) rate was 74.7% at 3 years, 60.5% at 5 years, and 45.8% at 10 years. Disease-free survival (DFS) rate was 67.2% at 3 years, 45.6% at 5 years, and 30.8% at 10 years. There was significant difference in OS rate among different pathological types (χ2 = 14.18, P < 0.05). The order of 5-year OS rate was as follows: malignant transformation of inverted Papilloma (77.7%) > adenoid cystic carcinoma (74.1%) > squamous cell carcinoma (48.4%) > sarcoma (22.1%). The order of disease-free survival was as follows: total maxillary resection > subtotal maxillary resection > endoscopic nasal tumor resection ≥enlarged maxillary resection, the 5-year DFS rate were 68.6%, 53.5%, 46.2%, and 42.9%, respectively. The OS of postoperative radiotherapy was significantly better than that of preoperative radiotherapy (χ2 = 7.16, P < 0.05). There was significant difference in OS between recurrent and non-recurrent patients (χ2 = 68.57, P < 0.05). Conclusions The pathological type and the timing of radiotherapy are independent prognostic factors for primary malignant tumor of maxillary sinus. In addition, different local surgical resection methods are independent factors affecting the recurrence rate.

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Maxillary reconstruction using rectus femoris muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle

Cited by 6 publications

References 26 publications

Speech and swallowing function following microsurgical reconstruction of palatal defects in a series of six pediatric patients

Speech and swallowing function following microsurgical reconstruction of palatal defects in a series of six pediatric patients

Chimeric Anterolateral Thigh and Rectus Femoris Flaps for Reconstruction of Complex Oral and Maxillofacial Defects

Prognostic Analysis of Individualized Treatments of Malignant Tumors Primary From Maxillary Sinus

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