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 .
Status | Not yet recruiting |
Enrollment | 30 |
Est. completion date | October 2025 |
Est. primary completion date | September 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A to 75 Years |
Eligibility |
Inclusion Criteria: 1. All patients post maxillectomy due to benign maxillary lesions. 2. All patients post maxillectomy with malignant maxillary swelling with no distant metastases. 3. All patients which implants are needed after surgery for head and neck neoplasia . Exclusion Criteria: 1. Oropharyngeal, Nasopharyngeal, and Hypopharyngeal cancers, and lip cancers;. 2. Recurrent tumors resulting in implant loss. 3. Previous free flap harvest from scapula. |
Country | Name | City | State |
---|---|---|---|
Egypt | Assiut University | Assiut |
Lead Sponsor | Collaborator |
---|---|
hassan harby mohamed |
Egypt,
Sarukawa S, Kamochi H, Noguchi T, Sunaga A, Uda H, Mori Y, Nishino H, Yoshimura K. Free-flap surgical correction of facial deformity after anteromedial maxillectomy. J Craniomaxillofac Surg. 2017 Sep;45(9):1573-1577. doi: 10.1016/j.jcms.2017.06.020. Epub 2017 Jul 6. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | reconstruction and restoration of facial contour. | reconstruction of the maxilla by provide rigid bony support post maxillectomy with measurement of graft taken and union occur by follow up with MSCT of the facial bone with 3D film . | 6 month |
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