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Horizontal maxillary osteotomy with interpositional fibula flap.

Rachel Bluebond-Langner1, Lisa R Witkin, Eduardo D Rodriguez

  • 1Johns Hopkins University School of Medicine, R. Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.

The Journal of Craniofacial Surgery
|September 25, 2008
PubMed
Summary
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Horizontal maxillary osteotomy with fibula flaps corrects maxillary deficiency in all dimensions. This vascularized bone graft technique offers stable, long-term reconstruction with reduced resorption compared to conventional methods.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Plastic and Reconstructive Surgery
  • Biomaterials Science

Background:

  • Maxillary deficiency presents complex challenges in vertical, anterior-posterior, and transverse dimensions.
  • Conventional reconstruction methods may lead to significant bone resorption and instability.
  • Vascularized bone flaps offer advantages in compromised surgical sites.

Purpose of the Study:

  • To evaluate the efficacy of horizontal maxillary osteotomy with interpositional fibula flaps for maxillary reconstruction.
  • To assess the long-term stability and outcomes of this technique.
  • To compare vascularized fibula flaps with nonvascularized bone grafts.

Main Methods:

  • Retrospective review of patients with maxillary hypoplasia.

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  • Surgical technique involving horizontal maxillary osteotomy and interpositional osteoseptocutaneous fibula flaps.
  • Assessment of bony and soft tissue reconstruction outcomes.

    • Main Results:

    • The technique successfully corrected maxillary deficiencies in all three planes.
    • Vascularized fibula flaps demonstrated long-term stable constructs.
    • Reduced bone resorption was observed compared to nonvascularized grafts.
    • The technique is suitable for poorly vascularized or compromised wound beds.

    Conclusions:

    • Horizontal maxillary osteotomy with interpositional fibula flaps is an effective method for comprehensive maxillary reconstruction.
    • This technique provides stable, long-term results with improved bone maintenance.
    • Vascularized fibula flaps are advantageous in complex cases, including those with poor vascularity or prior radiation.