Reconstruction of the Midface with Vascularized Bone and Soft Tissue

ABSTRACT

Because of its anatomical location and complexity, the midface has been a challenging area to approach with reconstructive techniques. Its three-dimensional nature and importance in the functions of alimentation and respiration make the reconstruction of the midface imperative to survival and quality of life. Previously used methods relied primarily on prosthetic devices and local flaps, which were frequently inadequate. Thoracic musculocutaneous flaps are limited in their arcs of rotation and are of only moderate value in this area. Microvascular free tissue transfer has greatly improved results in both appearance and function. Three-dimensional manipulation of osteocutaneous flaps, such as the radial forearm and the scapula, or soft tissue flaps, such as latissimus dorsi, rectus abdominis, omentum and scapula, can be employed to satisfy almost any defect. The nature of the defect analyzed as either contour or complex three-dimensional, with other factors, will determine which flap is most useful.

KEYWORDS

Midface - free flap - cancer - head reconstruction - neck reconstruction

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