The intraoral anastomosing technique in reconstructive surgery of the face – A consecutive case series of 70 patients

Brandtner, Christian; Bürger, Heinz; Hachleitner, Johannes; Gaggl, Alexander

doi:10.1016/j.jcms.2015.07.017

Cited by 25 publications

(17 citation statements)

References 42 publications

(17 reference statements)

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“… 2 Several reports of intraoral anastomoses for microvascular mandibular, maxillary, and palatal reconstruction also exist for smaller defects. 10 To our knowledge, this is the first report of a 3-segment subtotal mandibular free flap reconstruction making use of VSP, patient-specific cutting guides, and reconstruction plate accomplished entirely without cutaneous incisions. This approach is ideal in cases where a neck dissection is not necessary, which may limit its use in head and neck cancers.…”

Section: Discussionmentioning

confidence: 90%

Subtotal Mandible Reconstruction with a Free Fibula Flap and No Skin Incisions

Lim

Mulloy

Stern‐Buchbinder

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Summary: Resection of large mandibular tumors followed by primary reconstruction using free tissue transfer is typically accomplished using transcutaneous cervical incisions, which provide access for ablation as well as inset of the osseous free flap. This approach offers wide exposure; however, it subjects the patient to potential facial scarring, marginal mandibular nerve injury, lip deformity/incompetence, formation of orocutaneous fistulae, as well as functional impairments to speech, mastication, and deglutition. To reduce morbidity and to preserve aesthetics, a transoral approach can be used in cases that do not require a neck dissection. This technique can be coupled with transoral dissection of the facial vessels for intraoral microanastomoses to avoid extraoral incisions altogether. We present a case of a large 17.2 cm subtotal mandibulectomy and 3-segment fibular free flap reconstruction using virtual surgical planning, with patient-specific cutting guides and reconstruction plate performed entirely transorally without any skin incisions. Although technically challenging, this is a safe and effective technique for large segmental mandibular defects, which provides superior cosmetic and functional outcomes.

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Section: Discussionmentioning

confidence: 90%

Subtotal Mandible Reconstruction with a Free Fibula Flap and No Skin Incisions

Lim

Mulloy

Stern‐Buchbinder

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…In an attempt to overcome pedicle length issues some authors have adapted the recipient vessels to utilize the facial vessels above the mandible, both externally (Revenaugh et al 8 ) and more recently with an intraoral approach. [9][10][11][12][13][14] For the external approach, face lift incisions or nasolabial incisions are the most common incisions. Although the external approach has the advantage of reducing pedicle length requirements, there is a higher risk of marginal mandibular nerve palsy as the facial nerve branches overlie the facial artery and vein in the midface.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Buccal Space Approach for Midface Free Flap Reconstruction

2022

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This article describes a transbuccal approach to reach the facial vessels. The anatomy of this intraoral approach is predictable, minimizing the risk of facial nerve dysfunction. This technique provides the possibility of free flap midface reconstruction with short pedicles and avoids the need to use vein grafts. Moreover, it is esthetically preferable. Through cadaver dissection and anatomical drawings, we describe extensively the different surgical steps. Using the combination of the previous knowledge and recent anatomical understandings, we can provide a reliable step-by-step approach to find the facial artery and vein through a transbuccal approach for microvascular midface free flap repair.

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“…23 Intra-oral anastomosis is utilized as an additional refinement for free flap reconstruction of these defects. 24,25 In our series, we utilized the medial sural artery perforator (MSAP) flap as a relatively novel way to reconstruct alveolar defects with free flap reconstruction first and staged alveolar bone graft. We also employed osteocutaneous forearm flap for alveolar defects for simultaneous soft tissue and bone reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Craniofacial Microsurgery: An Integrated Approach to Management of Cleft and Craniofacial Syndromes, Surgical Experience, and Insights

Sachanandani

Powers

Issa

et al. 2021

Journal of Craniofacial Surgery

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I n this study, the Sachnandani et al review their experience with performing microsurgical reconstruction in 17 patients with cleft and craniofacial syndromes, conditions that are usually treated by those with craniofacial fellowship training using local and regional flaps as well as bone and cartilage grafts. While the idea of using free flaps for congenital craniofacial defects is not necessarily a new From the

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The intraoral anastomosing technique in reconstructive surgery of the face – A consecutive case series of 70 patients

Cited by 25 publications

References 42 publications

Subtotal Mandible Reconstruction with a Free Fibula Flap and No Skin Incisions

Subtotal Mandible Reconstruction with a Free Fibula Flap and No Skin Incisions

A Buccal Space Approach for Midface Free Flap Reconstruction

Craniofacial Microsurgery: An Integrated Approach to Management of Cleft and Craniofacial Syndromes, Surgical Experience, and Insights

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