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Semin Plast Surg 2008; 22(3): 141-155
DOI: 10.1055/s-2008-1081398
© Thieme Medical Publishers

Reconstruction of Head and Neck Defects: A Systematic Approach to Treatment

Deepak Kademani1 , Samir Mardini2 , Steven L. Moran2
  • 1Division of Oral and Maxillofacial Surgery, University of Minnesota Medical Center, Minneapolis, Minnesota
  • 2Plastic Surgery and Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
Further Information

Publication History

Publication Date:
22 October 2008 (online)

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ABSTRACT

Reconstruction of composite maxillofacial defects after tumor excision or trauma is difficult. The role of the reconstructive surgeon is to have a diverse armamentarium of reconstructive options to enable an aesthetic and functional reconstruction while minimizing the morbidity to the patient. This article will present a systematic review of composite maxillofacial reconstruction with free tissue transfer.

KEYWORDS

Reconstruction - maxilla - mandible - osteocutaneous free flaps

REFERENCES

  • 1 Gilbert A. Vascularized transfer of the fibula shaft.  Int J Microsurg. 1979;  1 100
    PubMedGoogle Scholar
  • 2 Gilbert A, Teot L. The free scapular flap.  Plast Reconstr Surg. 1982;  69 601-604
    CrossrefPubMedGoogle Scholar
  • 3 Hidalgo D. Fibula free flap; a new method of mandible reconstruction.  Plast Reconstr Surg. 1989;  84 71-79
    Google Scholar
  • 4 Manchester W. Immediate reconstruction of the mandible and the TMJ.  Br J Plast Surg. 1965;  18 291-303
    CrossrefPubMedGoogle Scholar
  • 5 Taylor G, Miller D FJH. The free vascularized bone graft: a clinical extension of microvascular techniques.  Plast Reconstr Surg. 1975;  55 533-544
    Google Scholar
  • 6 Urken M. Composite free flaps in oromandibular reconstruction; a review of the literature.  Arch Otolaryngol Head Neck Surg. 1991;  117 724-732
    CrossrefPubMedGoogle Scholar
  • 7 Wei F, Chen H, Chuang C, Nordroff M. Fibular osteocutaneous flap: anatomic study and clinical application.  Plast Reconstr Surg. 1986;  78 191-200
    CrossrefPubMedGoogle Scholar
  • 8 Kademani D, Keller E. Iliac crest grafting for mandibular reconstruction.  Atlas Oral Maxillofac Surg Clin North Am. 2006;  14 161-170
    PubMedGoogle Scholar
  • 9 Brown J S. Deep circumflex iliac artery free flap with internal oblique muscle as a new method of immediate reconstruction of maxillectomy defect.  Head Neck. 1996;  18 412-421
    CrossrefPubMedGoogle Scholar
  • 10 Wei F, Seah C, Tsai Y, Liu S. Fibula osetoseptocutaneous flap for reconstruction of composite mandibular defects.  Plast Reconstr Surg. 1994;  93 294-304
    CrossrefPubMedGoogle Scholar
  • 11 Chopra S, Enepekides D J. The role of distraction osteogenesis in mandibular reconstruction.  Curr Opin Otolaryngol Head Neck Surg. 2007;  15 197-201
    CrossrefPubMedGoogle Scholar
  • 12 Eski M, Turegun M, Deveci M, Gokce H S, Sengezer M. Vertical distraction osteogenesis of fibular bone flap in reconstructed mandible.  Ann Plast Surg. 2006;  57 631-636
    CrossrefPubMedGoogle Scholar
  • 13 Friedrich R E, Schmelzle R. Distraction osteogenesis of a fibula free flap used for mandibular reconstruction: preliminary report Sergio Siciliano, Benoit Lengere, Henre Reychler.  , [comment] J Craniomaxillofac Surg. 1999;  27 398
    PubMedGoogle Scholar
  • 14 Kessler P, Schultze-Mosgau S, Neukam F W, Wiltfang J. Lengthening of the reconstructed mandible using extraoral distraction devices: report of five cases.  Plast Reconstr Surg. 2003;  111 1400-1404 discussion 1405-1406
    CrossrefPubMedGoogle Scholar
  • 15 Klesper B, Lazar F, Siessegger M, Hidding J, Zoller J E. Vertical distraction osteogenesis of fibula transplants for mandibular reconstruction—a preliminary study.  J Craniomaxillofac Surg. 2002;  30 280-285
    PubMedGoogle Scholar
  • 16 Levin L, Carrasco L, Kazemi A, Chalian A. Enhancement of the fibula free flap by alveolar distraction for dental implant restoration: report of a case.  Facial Plast Surg. 2003;  19 87-94
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Marchetti C, Degidi M, Scarano A, Piattelli A. Vertical distraction osteogenesis of fibular free flap in mandibular prosthetic rehabilitation: a case report.  Int J Periodontics Restorative Dent. 2002;  22 251-257
    PubMedGoogle Scholar
  • 18 Mehta R P, Deschler D G. Mandibular reconstruction in 2004: an analysis of different techniques.  Curr Opin Otolaryngol Head Neck Surg. 2004;  12 288-293
    CrossrefPubMedGoogle Scholar
  • 19 Ortakoglu K, Suer B T, Ozyigit A, Ozen T, Sencimen M. Vertical distraction osteogenesis of fibula transplant for mandibular reconstruction: a case report.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;  102 e8-e11
    CrossrefPubMedGoogle Scholar
  • 20 Siciliano S, Lengele B, Reychler H. Distraction osteogenesis of a fibula free flap used for mandibular reconstruction: preliminary report.  , [see comment] J Craniomaxillofac Surg. 1998;  26 386-390
    PubMedGoogle Scholar
  • 21 Zhang C, Zhang Z. Reconstruction of mandible with fibular flap and dental implant distractor: a new approach.  Chin Med J (Engl). 2002;  115 1877-1880
    PubMedGoogle Scholar
  • 22 Bianchi B, Ferrari S, Poli T, Bertolini F, Raho T, Sesenna E. Oromandibular reconstruction with simultaneous free flaps: experience on 10 cases.  Acta Otorhinolaryngol Ital. 2003;  23 281-290
    PubMedGoogle Scholar
  • 23 Chen H C, Demirkan F, Wei F C, Cheng S L, Cheng M H, Chen I H. Free fibula osteoseptocutaneous-pedicled pectoralis major myocutaneous flap combination in reconstruction of extensive composite mandibular defects.  Plast Reconstr Surg. 1999;  103 839-845
    CrossrefPubMedGoogle Scholar
  • 24 Demirkan F, Wei F C, Chen H C, Chen I H, Liao C T. Oromandibular reconstruction using a third free flap in sequence in recurrent carcinoma.  Br J Plast Surg. 1999;  52 429-433
    CrossrefPubMedGoogle Scholar
  • 25 Jeng S F, Kuo Y R, Wei F C, Su C Y, Chien C Y. Reconstruction of extensive composite mandibular defects with large lip involvement by using double free flaps and fascia lata grafts for oral sphincters.  Plast Reconstr Surg. 2005;  115 1830-1836
    CrossrefPubMedGoogle Scholar
  • 26 Kuzon Jr W M, Jejurikar S, Wilkins E G, Swartz W M. Double free-flap reconstruction of massive defects involving the lip, chin, and mandible.  Microsurgery. 1998;  18 372-378
    CrossrefPubMedGoogle Scholar
  • 27 Posch N A, Mureau M A, Dumans A G, Hofer S O. Functional and aesthetic outcome and survival after double free flap reconstruction in advanced head and neck cancer patients.  Plast Reconstr Surg. 2007;  120 124-129
    CrossrefPubMedGoogle Scholar
  • 28 Wei F C, Demirkan F, Chen H C, Chen I H. Double free flaps in reconstruction of extensive composite mandibular defects in head and neck cancer.  Plast Reconstr Surg. 1999;  103 39-47
    CrossrefPubMedGoogle Scholar
  • 29 Schoning H, Emshoff R. Primary temporary AO plate reconstruction of the mandible.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;  86 667-672
    CrossrefPubMedGoogle Scholar
  • 30 Hidalgo D A. Titanium miniplate fixation in free flap mandible reconstruction.  Ann Plast Surg. 1989;  23 498-507
    CrossrefPubMedGoogle Scholar
  • 31 Hidalgo D A. Fibula free flap: a new method of mandible reconstruction.  Plast Reconstr Surg. 1989;  84 71-79
    Google Scholar
  • 32 Hidalgo D A. Condyle transplantation in free flap mandible reconstruction.  Plast Reconstr Surg. 1994;  93 770-781 discussion 782-773
    CrossrefPubMedGoogle Scholar
  • 33 Shah J P, Haribhakti V, Loree T, Sutaria P. Complication of the pectoralis major myocutaneous flap in head and neck reconstruction.  Am J Surg. 1990;  160 352-355
    CrossrefPubMedGoogle Scholar
  • 34 Soutar D S, Scheker L, Tanner N, McGregor I. The radial forearm free flap: a versatile method for intraoral reconstruction.  Br J Plast Surg. 1983;  36 1-8
    CrossrefPubMedGoogle Scholar
  • 35 Disa J J, Pusic A L, Hidalgo D H, Cordeiro P G. Simplifying microvascular head and neck reconstruction: a rational approach to donor site selection.  , [see comment] Ann Plast Surg. 2001;  47 385-389
    Google Scholar
  • 36 Futran N D, Haller J R. Considerations for free-flap reconstruction of the hard palate.  Arch Otolaryngol Head Neck Surg. 1999;  125 665-669
    CrossrefPubMedGoogle Scholar
  • 37 Kademani D, Moran S. Medial femoral periosteal free flap. A novel method of maxillary reconstruction.  Int. J Oral Maxillofac Surg. 2007;  36 1057
    PubMedGoogle Scholar

Deepak KademaniD.M.D. M.D. F.A.C.S. 

Division of Oral and Maxillofacial Surgery University of Minnesota Medical Center

Moosetower 7-174G, 515 Delar Street, Minn. MN 5545

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