Maxillary Neoplasms Clinical Trial
Official title:
Reconstruction of Maxillary and Midfacial Defects Using Latissimus Dorsi Scapular Free Flaps
Bony reconstruction of the midface with free tissue transfer is complex and challenging due
to structural considerations such as the need for orbital support, patency of the nasal
cavity, restoration of the palate and alveolus and skull base support when needed. As a
result, bony reconstruction is important especially for patients who experience diplopia,
hypoglobus and enophthalmos postoperatively.
Orocutaneous and nasocutaneous fistulae and infection due to communication with the oral
cavity or sinuses are also common complication . Finally, cosmetic deformities from
inadequate projection are also a concern.
Cosmetic and functional outcomes are improved with bony reconstruction as it is able to
provide rigid support of key structures, restoration of contour, affords the possibility of
dental rehabilitation and is less likely to contract significantly following radiation
treatment.
Subscapular system free flaps (SF) are uniquely suited to address the needs of midface
reconstruction. A substantial amount of bone can be harvested from the lateral scapular
border and scapular tip, each with different shapes and thicknesses. Chimeric flaps can be
harvested in various combinations, adding Para scapular and scapular skin paddles, latissimus
muscle (with or without skin), serratus muscle and rib. Additionally, due to the vascular
organization of this network, these components can be harvested off separate pedicles,
offering great flexibility and freedom of movement relative to each other .
reconstruction of defects post maxiilectomy by scapular free flaps ;
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