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Abdelmofeed AM, Hassan ME, Seif O, Abdelhalim MH, Younes MT. Extended Pedicled Perforator Plus Submental Flap for Large Cheek Defect Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4997. [PMID: 37360243 PMCID: PMC10287118 DOI: 10.1097/gox.0000000000004997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/14/2023] [Indexed: 06/28/2023]
Abstract
The submental flap is an alternative repair technique in the maxillo-facial region when microsurgical reconstruction is not required or is difficult to apply. The purpose of this study was to illustrate the benefits of restoring the cheeks with an extended pedicled submental flap. Method Eight patients aged 58 to 81 years with cheek cancer presented to the surgery department at the Benha University Hospital in Egypt, from May 2019 to October 2021 for the removal of their tumors and reconstruction of the resulting defects, using the extended submental perforator plus pedicled artery flap. Results The average blood loss was 250 cm3 (range: 50-400 cm3). The average operation took 3 hours to complete, including excision and rebuilding (a range of 2.5 to 3.5 hours). The length of the postoperative hospital stay was 2 to 4 days. Fortunately, there was no complete flap loss; nonetheless, distal flap necrosis in one case left a raw area, which was allowed to heal naturally, and hemorrhages in two cases were conservatively handled. Conclusions For the reconstruction of cheek abnormalities, the submental flap is a viable alternative, particularly in older patients or patients whose overall health has declined and who need less severe therapies and quicker surgery. The submental flap, which conceals the donor site, provides a dependable supply of skin for facial resurfacing with excellent color, shape, and texture matching. The flap is quick, and easy to raise.
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Affiliation(s)
- Ayman M. Abdelmofeed
- From the Department of General Surgery, Plastic Surgery Unit, Benha University, Benha City, Egypt
| | | | - Ola Seif
- From the Department of General Surgery, Plastic Surgery Unit, Benha University, Benha City, Egypt
| | - Mohamed H. Abdelhalim
- From the Department of General Surgery, Plastic Surgery Unit, Benha University, Benha City, Egypt
| | - Mohamed T. Younes
- From the Department of General Surgery, Plastic Surgery Unit, Benha University, Benha City, Egypt
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Reverse Facial-Submental Artery Osteomyocutaneous Flap, a Novel Choice for Previously Operated Huge Alveolar Clefts. World J Plast Surg 2022; 11:109-115. [PMID: 36694678 PMCID: PMC9840765 DOI: 10.52547/wjps.11.3.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022] Open
Abstract
Adult previously operated alveolar cleft palate presents a pronounced challenge for optimal surgical reconstruction. This optimal reconstruction dictates the restoration of soft tissues in addition to hard tissues to achieve prime functional results. Regional flaps usually used for the reconstruction of such defects were considered as either bulky or none bone bearing flaps. Furthermore, using free flaps for reconstruction can rise the concerns of increased intraoperative complications and greater suspected donor site morbidities. Here we present three unfavorably previously operated patients with current huge alveolar cleft palates, planned for the reconstruction with reverse facial-submental artery osteomyocutaneous flap. Besides, detailed flap harvesting technique, results, prosthetic restoration post to flap surgery, and follow up are presented in this article. We found the reverse facial- submental osteomyocutaneous flap as a novel and reliable choice for functional reconstruction of challenging huge alveolar cleft palates. The reverse facial-submental flap has not been yet mentioned in the medical literature for the reconstruction of alveolar clefts.
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Reconstruction of Large Acquired Palatal Defects Using Facial-Submental Artery Island Flap. J Craniofac Surg 2021; 33:e153-e156. [PMID: 34560748 DOI: 10.1097/scs.0000000000008203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility and clinical effect of facial-submental artery island flap (FSAIF) in the repair of palatal defects, and to provide reference for the clinical application of submental artery island flap. METHODS Nine patients with palatal defects, the range of nasal palatal perforation defects were 3 cm × 4cm to 3 cm × 6 cm (median 3 cm × 5.4 cm), were repaired by FSAIF, and the sizes of FSAIF were 4 cm × 9cm to 4 cm × 12 cm (median 4 cm × 10.4 cm,). Postoperative clinical efficacy was evaluated, including infection and necrosis of mucosal flap and postoperative palatal fistula perforation. Patients were followed up to evaluate their chewing, swallowing, speech function, and satisfaction of appearance. RESULTS All patients were successfully repaired with FSAIF. Followed up 13∼35 months, there was no palatal fistula perforation in all patients. The speech, agitation, and swallowing function were not affected and the patients were satisfied with the appearance. CONCLUSION FSAIF is a safe and reliable method for palatal defect repair.
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Chen WL, Wang YY, Zhou B, Wen ZZ, Yuan KF, Chen YJ. Survival and functional outcomes of patients who underwent facial-submental artery island flap reconstruction after oral cavity or HPV-negative oropharyngeal squamous cell carcinoma ablation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:383-389. [DOI: 10.1016/j.jormas.2019.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/10/2023]
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Hanna TC, Gates JC, Kraus DH. Vertical Submental Island Flap for Head and Neck Reconstruction. J Oral Maxillofac Surg 2020; 78:1653.e1-1653.e6. [PMID: 32428462 DOI: 10.1016/j.joms.2020.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/30/2020] [Accepted: 05/04/2020] [Indexed: 11/16/2022]
Abstract
Regional flaps remain a cornerstone of head and neck reconstruction. Among their many functions, they serve a vital role in salvage surgery and for those in whom medical comorbidities preclude the use of microvascular free flaps. Recent research has also examined their potential benefit in value-based healthcare metrics such as operative time, cost, intensive care unit care, and length of stay as compared to free-flap reconstruction. The submental island flap is one such entity that is well described and validated to provide predictable, oncologically sound coverage for defects of the lower third of the face and oral cavity. Its application has also been documented for repair of defects of the midface, temporal region, oropharynx, and hypopharynx, albeit less frequently. Since its original description, there have been several modifications of this axial-based flap, though none of a vertically oriented long axis. We describe a case of a vertically based submental island flap for maxillary reconstruction that allowed for debulking and recontouring of prior pectoralis flap and correction of submental ptosis.
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Affiliation(s)
- Todd C Hanna
- Voluntary Faculty, New York Head and Neck Institute, Lenox Hill Hospital, Northwell Health, New York, NY
| | - James C Gates
- Instructor, Department of Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, PA.
| | - Dennis H Kraus
- Professor and Vice Chair, Department of Otolaryngology, Lenox Hill Hospital, Northwell Health; Director, Center for Head and Neck Oncology, New York Head and Neck Institute, Northwell Health, New York, NY
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Pan CB, Wang Y, Chen WL, Zhou B, Wang XM. Outcomes of younger and older patients with palatal cancer undergoing pedicled facial-submental artery island flap reconstruction. Int J Oral Maxillofac Surg 2020; 49:7-12. [DOI: 10.1016/j.ijom.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 03/16/2019] [Accepted: 05/31/2019] [Indexed: 12/15/2022]
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Discussion: Twenty-Five Years of Experience with the Submental Flap in Facial Reconstruction: Evolution and Technical Refinements following 311 Cases in Europe and Africa. Plast Reconstr Surg 2019; 143:1759-1760. [PMID: 31136494 DOI: 10.1097/prs.0000000000005679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Reconstruction with submental flap for aggressive orofacial cancer- an updated series. Am J Otolaryngol 2018; 39:693-697. [PMID: 30076021 DOI: 10.1016/j.amjoto.2018.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/24/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE Submental flap is gaining popularity for head and neck reconstruction. We have reported in 2007 our early experience of using submental flap for aggressive orofacial malignancy. Novel flap design and application is described in this updated series. MATERIALS AND METHODS 15 patients who had received submental flap reconstruction after extirpation of newly diagnosed aggressive orofacial lesions were retrieved. The details of the flap harvest was studied for flap size, inclusion of mylohyoid muscle, antegrade versus retrograde blood supply, and compared with our previous series. RESULTS The dimension of flap skin paddle was 30cm2 (range 20-72). Retrograde pedicle flow was used in 2(13.3%) patients. Mylohyoid muscle was included in the flap in 6(40%) patients. There was no total flap necrosis while partial flap necrosis occurred in 1 patient(6.7%). There was a significant increase of inclusion of mylohyoid muscle to the flap in this series (p = 0.02). Novel techniques including double-paddled flap skin to resurface full-thickness defect and chimeric osteocutaneous mandible submental flap for maxillary defect were successfully performed. CONCLUSIONS Submental flap is a viable reconstructive option in selected patients with aggressive orofacial malignancy. The indications are expanding and its technical modification is evolving and resulting in more innovative applications.
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Wang W, Xu B, Zhu J, Yang C, Shen S, Qian Y. Maxillary reconstruction using rectus femoris muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle. Med Oral Patol Oral Cir Bucal 2018; 23:e619-e624. [PMID: 30148478 PMCID: PMC6167095 DOI: 10.4317/medoral.22505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/04/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Maxillary reconstruction using various pedicled and free-tissue transfer techniques with bone graft or without bone graft has some drawbacks. In this study, we demonstrate maxillary reconstruction using femoris rectus muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle through the modified lateral lip-submandibular approach. MATERIAL AND METHODS Nine patients suffering from maxillary defects secondary to maxillary cancer ablation, who underwent maxillary reconstruction using rectus femoris muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle, were enrolled into this study between November 2015 and August 2017. RESULTS All patients who underwent the maxillary reconstruction using femoris rectus muscle flap and sagittal mandibular ramus/coronoid process graft pedicled with temporalis muscle presented satisfactory postoperative function, with adequate mouth opening, optimal esthetic outcome and no restrictions on the diet. Every rectus femoris muscle flaps mucosalized well within five weeks. No donor site functional impairment or complications were observed. CONCLUSIONS The technique is a feasible and acceptable technique for the maxillary reconstructions. It is safe, quick and simple to harvest. It also presents an optimal esthetic and satisfactory functional outcome with the advantage of low morbidity of the donor site. Combined with the three-dimension reconstruction, this technique can improve the postoperative outcomes.
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Affiliation(s)
- W Wang
- No. 1088 Mid Hai Yuan Road Gaoxin District, Kunming Yunnan 650106, China,
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Maxillary Reconstruction Using Submental Artery Island Flap and Sagittal Mandibular Ramus/Coronoid Process Graft Pedicled With Temporalis Muscle. J Oral Maxillofac Surg 2017; 75:2271.e1-2271.e6. [PMID: 28738192 DOI: 10.1016/j.joms.2017.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/20/2017] [Accepted: 06/20/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to describe maxillary reconstruction using the submental artery island flap and the sagittal mandibular ramus and coronoid process graft pedicled with the temporalis muscle through the modified lateral lip and submandibular approach. MATERIALS AND METHODS From May 2013 to September 2016, 11 patients with maxillary defects secondary to maxillary cancer ablation who underwent maxillary reconstruction using a submental artery island flap and a sagittal mandibular ramus and coronoid process graft pedicled with the temporalis muscle through the modified lateral lip and submandibular approach were enrolled in this prospective study. RESULTS All submental artery island flaps and sagittal mandibular ramus and coronoid process grafts were successful, with satisfactory functional and esthetic outcomes. No functional impairment at the donor site occurred in any case. CONCLUSION The submental artery island flap combined with the sagittal mandibular ramus and coronoid process graft is a feasible and acceptable technique for maxillary reconstruction in older patients because it is safe, quick, and straightforward to harvest and it offers a very acceptable esthetic and satisfactory outcome, with the advantage of low morbidity of the donor site. When combined with the 3-dimensional virtual operative method, the technique can improve postoperative outcomes.
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Chow TL, Fung SC, Choi CY, Ho LI, Kwan WW. Maxillary reconstruction with pedicled reverse-flow submental osteocutaneous mandible chimeric flap. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2016. [DOI: 10.1016/j.ajoms.2016.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chen WL, Yang ZH, Huang ZQ, Fan S, Zhang DM, Wang YY. Craniofacial Resection and Reconstruction in Patients With Recurrent Cancer Involving the Craniomaxillofacial Region. J Oral Maxillofac Surg 2016; 75:622-631. [PMID: 27717818 DOI: 10.1016/j.joms.2016.08.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 08/24/2016] [Accepted: 08/29/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Head and neck tumors that involve the craniomaxillofacial region are classified as stage IVb disease and are clinically challenging. In this study, the outcomes of craniofacial resection and craniofacial reconstruction in patients with recurrent malignant tumors involving the craniomaxillofacial region were evaluated. PATIENTS AND METHODS This retrospective observational study was conducted from January 2008 to August 2015. Data collected for each patient included age, gender, tumor site, initial treatment, craniofacial resection, reconstruction flaps and complications after craniofacial resection, adjuvant treatment, and reported outcomes of craniofacial resection and craniofacial reconstruction. The χ2 test in SPSS was used to analyze the data. RESULTS Twenty-four patients with recurrent malignant tumors involving the craniomaxillofacial region were identified who had undergone craniofacial resection at the Center of Craniomaxillofacial Surgery of Sun Yat-sen University (Guangzhou, Guangdong, China). The study population was comprised of 24 patients (15 men and 9 women; age range, 21 to 73 yr) with recurrent tumors (58.3% with squamous cell carcinoma [SCC], 41.7% with sarcoma [SA]) involving the craniomaxillofacial region who underwent craniofacial resection. Craniofacial resection consisted of orbital exenteration and maxillotomy; anterior skull base surgery, facial resection, and mandibulotomy; or ipsilateral radical neck dissection. The resultant craniomaxillofacial defects were reconstructed using extended vertical lower trapezius island myocutaneous flaps (TIMFs), temporalis myofascial flaps, or submental flaps. All patients with recurrent malignant tumor involving the craniomaxillofacial region underwent gross total resection of the tumor; 22 patients underwent craniofacial reconstruction. There were no major surgical complications. Minor flap failure and wound dehiscence in the donor site occurred in 4 patients. The follow-up period ranged from 8 to 36 months. Seven patients in the SCC group and 7 in the SA group were alive with no evidence of disease (AND), 3 in the SCC group and 2 in the SA group were alive with disease (AWD), and 4 in the SCC and 1 in the SA group died of the disease (DOD) after local recurrence or distant metastases at 8 to 18 months. There were no statistical differences among the AND, AWD, and DOD groups. CONCLUSIONS Craniofacial resection remains an effective salvage treatment for patients with recurrent SCC and SA involving the craniomaxillofacial region. The extended vertical lower TIMF is a large, simple, and reliable flap for reconstructing major defects after a craniofacial resection.
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Affiliation(s)
- Wei-Liang Chen
- Professor and Director, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Zhao-Hui Yang
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Quan Huang
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Song Fan
- Attending, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Da-Ming Zhang
- Attending, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - You-Yuan Wang
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Schonauer F, Di Martino A, Nele G, Santoro M, Dell’Aversana Orabona G, Califano L. Submental flap as an alternative to microsurgical flap in intraoral post-oncological reconstruction in the elderly. Int J Surg 2016; 33 Suppl 1:S51-6. [DOI: 10.1016/j.ijsu.2016.05.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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García-de Marcos JA, Arroyo-Rodríguez S, Rey-Biel J. Submental Osteocutaneous Perforator Flap for Maxillary and Mandibular Reconstruction Following Tumor Resection. J Oral Maxillofac Surg 2015; 74:860.e1-9. [PMID: 26707542 DOI: 10.1016/j.joms.2015.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 11/11/2015] [Accepted: 11/14/2015] [Indexed: 11/26/2022]
Abstract
Many different flaps have been used for reconstruction of the oral mucosa and the maxilla and mandible after tumor resection. These flaps might contain bone and might be free or locoregional. This study presents 2 cases of intraoral reconstruction using a submental osteocutaneous perforator flap to reconstruct the maxilla in one case and the mandible in the other. A reverse-flow flap was used for maxillary reconstruction In these cases, the functional, esthetic, and oncologic outcomes were favorable at 9 and 12 months of follow-up.
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Affiliation(s)
- Jose A García-de Marcos
- Oral and Maxillofacial Staff Surgeon, Department of Oral and Maxillofacial Surgery, "Rey Juan Carlos" University Hospital, Madrid, Spain.
| | - Susana Arroyo-Rodríguez
- Department Head, Department of Oral and Maxillofacial Surgery, Albacete University Hospital, Albacete, Spain
| | - Juan Rey-Biel
- Department Head, Department of Oral and Maxillofacial Surgery, "Rey Juan Carlos" University Hospital, Madrid, Spain
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Rahpeyma A, Khajehahmadi S. Submental artery island flap in intraoral reconstruction: A review. J Craniomaxillofac Surg 2014; 42:983-9. [DOI: 10.1016/j.jcms.2014.01.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/18/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022] Open
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Zhang DM, Chen WL, Lin ZY, Yang ZH. Use of a folded reverse facial-submental artery submental island flap to reconstruct soft palate defects following cancer ablation. J Craniomaxillofac Surg 2014; 42:910-4. [DOI: 10.1016/j.jcms.2014.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/09/2013] [Accepted: 01/03/2014] [Indexed: 11/29/2022] Open
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Comparative study of the osseous healing process following three different techniques of bone augmentation in the mandible: an experimental study. Int J Oral Maxillofac Surg 2014; 43:1404-10. [PMID: 25091894 DOI: 10.1016/j.ijom.2014.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/27/2014] [Accepted: 07/14/2014] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the osseointegration of three different bone grafting techniques. Forty-eight mature New Zealand rabbits were divided randomly into three groups of 16 each. Horizontal augmentation was performed on the corpus of the mandible using three different techniques: free bone graft (FBG), free periosteal bone graft (PBG), pedicled bone flap (BF). The animals were sacrificed at postoperative weeks 1, 3, or 8. Specimens were decalcified for histological examination, and histomorphometric measurements were performed. The histological evaluation demonstrated bony fusion between the grafts and the augmented mandibular bone after 8 weeks in all groups. At week 8, the bone volume was significantly greater in the BF group than in the FBG (P<0.001) and PBG (P=0.001) groups, and also the trabecular thickness was significantly greater than in the FBG (P=0.015) and PBG (P=0.015) groups. Trabecular separation was significantly lower in the BF group than in the FBG group at week 8 (P=0.015). BF demonstrated greater osseous healing capacity compared to FBG and PBG. The preserved vascularization in BF improves the bone quality in mandibular bone augmentations.
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Abstract
Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.
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Affiliation(s)
- Subramania Iyer
- Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
| | - Krishnakumar Thankappan
- Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
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Rahpeyma A, Khajehahmadi S. Reconstruction of the maxilla by submental flap. ANZ J Surg 2014; 85:873-7. [DOI: 10.1111/ans.12638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Amin Rahpeyma
- Oral and Maxillofacial Surgery; Oral and Maxillofacial Diseases Research Center; School of Dentistry; Mashhad University of Medical Sciences; Mashhad Iran
| | - Saeedeh Khajehahmadi
- Oral and Maxillofacial Pathology; Dental Research Center; School of Dentistry; Mashhad University of Medical Sciences; Mashhad Iran
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Krishnamurthy A. A technical modification of the submental flap for reconstruction of verrucous lesions of the oral cavity. Indian J Surg Oncol 2014; 4:298-300. [PMID: 24426743 DOI: 10.1007/s13193-013-0247-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Arvind Krishnamurthy
- Surgical Oncology, Cancer Institute (WIA), 36, Sardar Patel Road, Adyar, Chennai, 600020 India
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