Surgical Management of Velopharyngeal Dysfunction: Outcome Analysis of Autogenous Posterior Pharyngeal Wall Augmentation

Foster, RD; Jp, Anthony; Mi, Singer; Mj, Kaplan; Ma, Pogrel; Sj, Mathes

doi:10.1097/00006534-199705000-00013

Cited by 31 publications

(1 citation statement)

References 6 publications

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“…[ 15 – 17 , 18 ] In recent years, use of a vascularized fibular osteocutaneous flap has become standard for reconstruction of the mandible. [ 19 ] Fibular flap has a long length of good-quality bone and a sufficient blood supply suitable for stable osteosynthesis. The perforators of the peroneal artery permit the inclusion of a reliable skin paddle in the fibular flap for better reconstruction of the soft tissue.…”

Section: Discussionmentioning

confidence: 99%

Management strategy in patient with familial gigantiform cementoma

Wang

Ma²,

Qin³

et al. 2017

Medicine

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Rationale:Familial gigantiform cementoma (FGC) is a rare benign autosomal dominant fibrocemento-osseous lesion generally limited to the facial bones, typically in the anterior portion of the mandible; it is often associated with abnormalities of the long bones and prepubertal pathologic fractures. Owing to the small number of such patients, a uniform treatment criterion has not been established. This paper presents a patient with FGC who was treated in our department, and offers a systematic review of the patients reported in the literature. Our aim was to explore the treatment strategy for patients with FGC.Patient concerns:Our patient, a 13-year-old boy, presented with a painless enlargement of the mandible first noted 2 years earlier. It had grown rapidly over the preceding 8 months, affecting both his appearance and ability to chew.Diagnosis:Based on the pathologic, clinical, and radiographic features, FGC was diagnosed.Interventions:Mandibuloectomy was performed. The mandibular defect was immediately reconstructed with his right vascularized iliac crest flap. At the same time, a PubMed search was conducted to identify studies reporting on other patients with FGC.Outcomes:A 3-dimensional computed tomography (3D-CT) scan demonstrated appropriate height of the new alveolar bone. Follow-up results showed recovery of the patient's appearance and mandibular function. He was free of recurrence at 4-year follow-up.Lessons:FGC is a rare benign fibrocemento-osseous lesion of the jaws that can cause severe facial deformity. Incomplete removal leads to more rapid growth of the residual lesion. Therefore, extensive resection is a suitable strategy to avoid recurrence. Defects of the facial bones found intraoperatively should be repaired with resort to an appropriate donor site. However, it is important to be aware that patients with FGC always have concomitant abnormalities of skeletal metabolism and structure, as well as a vulnerability to fractures of the long bones of the lower extremity. Therefore, the optimal management strategy should include a review of treatment options for other patients as reported in the literature. An optimal protocol can not only provide sufficient high-quality bone suitable for the reconstruction of bone defects, but also minimize complications and maximize quality of life.

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Section: Discussionmentioning

confidence: 99%

Management strategy in patient with familial gigantiform cementoma

Wang

Ma²,

Qin³

et al. 2017

Medicine

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Midface Reconstruction With the Fibula Free Flap

Futran¹,

Wadsworth²,

Villaret³

et al. 2002

Arch Otolaryngol Head Neck Surg

158

114

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Use of the fibula osteocutaneous free flap to reconstruct the midface is highly reliable and our flap of choice for lower maxillary defects requiring bony reconstruction. However, when orbitozygomatic support is the primary objective, the utility of this flap is limited. Because of the complexity of this procedure, the choice of midface reconstruction technique should be individualized for each patient.

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Osseocutaneous Radial Forearm Free Tissue Transfer for Repair of Complex Midfacial Defects

Chepeha

Moyer²,

Bradford³

et al. 2005

Arch Otolaryngol Head Neck Surg

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To evaluate the resulting aesthetics, function, and donor site morbidity of the osseocutaneous radial forearm free flap (OCRFFF) used for midface reconstruction. Design: Prospective case series and a retrospective review of results. Patients: Ten patients from an academic practice who underwent reconstruction at the University of Michigan Hospitals between 1995 and 2001. Interventions: All patients had maxillectomy defects in which the entire infraorbital rim was reconstructed with an OCRFFF. Of the 10 patients included in the study, 3 underwent a total maxillectomy with orbital exenteration, 4 had a total maxillectomy without orbital exenteration, and 3 had a limited maxillectomy that did not involve the palate. Patients with palatal defects underwent reconstruction with a prosthetic palatal obturator. Main Outcome Measures: Facial contour and aesthetic results, speech understandability, ability to eat solid foods, oronasal separation, socializing outside the home, and return-to-work status. Flap success, donor site morbidity, and orbital complications were also studied. Results: Mean±SEM follow-up was 23.2±5.0 months. A modified Funk facial deformity scale was used, and 7 of the 10 patients had either no deformity or minimal deformity. The mean aesthetic score for these reconstructions was 2.1±0.3 on a scale of 1 to 4, with 1 representing no deformity and 4 representing a severe deformity. All patients returned to a solid diet and had understandable speech, although patients who had an orbital exenteration trended to poorer scores. All patients socialized either frequently or occasionally outside the home, and all patients not retired or disabled prior to surgery returned to work. Conclusion: The OCRFFF reconstruction of the infraorbital rim in patients with total maxillectomy defects and obturator of the palatal defect controls orbital complications and optimizes aesthetic outcome while achieving nearly normal palatal function.

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Surgical Management of Velopharyngeal Dysfunction: Outcome Analysis of Autogenous Posterior Pharyngeal Wall Augmentation

Cited by 31 publications

References 6 publications

Management strategy in patient with familial gigantiform cementoma

Management strategy in patient with familial gigantiform cementoma

Midface Reconstruction With the Fibula Free Flap

Osseocutaneous Radial Forearm Free Tissue Transfer for Repair of Complex Midfacial Defects

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