Reconstruction of maxillary defect with musculo‐adipose rectus free flap

Abstract

The MARF may be considered as an alternative to myocutaneous rectus free flap particularly for the reconstruction of maxillary defects in patients with central obesity. © 2015 Wiley Periodicals, Inc. Microsurgery 37:137-141, 2017.

Free double‐paddle superficial circumflex iliac perforator flap transfer for partial maxillectomy reconstruction: A case report

“…Partial maxillectomy defect can be treated with conservative epithelialization or skin grafting, but leading to significant problems in esthetics, diet, and speech due to velopharyngeal insufficiency (Andrades et al, 2011;Low et al, 2017;Wells & Luce, 1995;Zhang et al, 2011). Reconstruction should be done with a flap enough bulk to occupy a maxillectomy defect space and to reconstruct palate defect for velopharyngeal closure (Andrades et al, 2011;Low et al, 2017;Zhang et al, 2011). As perioperative radiotherapy is common for maxillary cancer treatment, bony reconstruction is basically recommended to achieve functional and esthetic reconstruction.…”

“…The present case showed uncommon postoperative course where radiotherapy was not performed due to the patient's refusal. When radiotherapy is not performed, soft tissue reconstruction with sufficient bulkiness is considered a choice of method to reconstruct a partial maxillectomy defect (Andrades et al, 2011;Low et al, 2017;Sailon et al, 2009;Yamamoto et al, 2015;Zhang et al, 2011). Although a single skin paddle flap can be used for the reconstruction by partially denuding the skin of the flap to close the palate defect, a doublepaddle skin flap is better suited to allow more physiological and anatomical reconstruction with resurfacing the oral and nasal sides (Andrades et al, 2011;Cordeiro & Disa, 2000;Zhang et al, 2011).…”

“…Maxillary defect after maxillectomy for maxillary sinus cancer treatment requires a bulky tissue to occupy the large-volume defect. Deep inferior epigastric artery-based lower abdominal flaps such as rectus abdominis myocutaneous (RAMC) flap and deep inferior epigastric artery perforator (DIEP) flap, and subscapular artery-based flaps such as lattisimus dorsi myocutaneous (LDMC) flap and scapular flap are commonly used, but necessitate invasive muscle dissection and a as large recipient vessel as a flap pedicle such as the facial artery (Andrades et al, 2011;Low et al, 2017;Zhang et al, 2011). Dissection or sacrifice of the rectus abdominis muscle may cause abdominal bulging or herniation (Low et al, 2017;Sailon et al, 2009;Zhang et al, 2011).…”

“…Unlike RAMC or DIEP flap, superficial abdominal flaps such as superficial inferior epigastric artery (SIEA) flap and SCIA and SCIP flap allow less invasive flap transfer without necessitating deep tissue dissection (Iida et al, 2014;Low et al, 2017;Sailon et al, 2009;Yamamoto et al, 2015;Yamamoto et al, 2016;Zhang et al, 2011). With intra-adiposal dissection, multiple perforator branches can be included in a SCIP flap to elevate a multi-paddle skin flap, which is useful for maxillectomy defect reconstruction of nasal and oral aspects.…”

Open Anterior Skull Base Reconstruction: A Contemporary Review

“…35,36 The rectus abdominus is classically the most well described and utilized free flap used in skull base reconstruction. [37][38][39] This musculocutaneous free flap is based off the very reliable deep inferior epigastric pedicle and offers a large area of skin that can be transferred as well as significant muscle bulk for closure of dead space. 31 The qualities that make the rectus abdominus an ideal soft tissue choice for open skull base reconstruction can also be found in latissimus dorsi, which similarly offers significant muscle bulk as well as a large skin area.…”