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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Maxillary reconstruction using anterolateral thigh flap and bone grafts.
Bernardo Bianchi1, Andrea Ferri, Silvano Ferrari
1Maxillo-Facial Surgery Division, Head and Neck Department, University and Hospital of Parma, Via Gramsci 14, Parma, Italy.
Microsurgery
|March 11, 2009
Summary
Reconstructing complex maxillary defects after tumor removal using anterolateral thigh free flaps combined with bone grafts offers good functional and esthetic outcomes. This surgical technique effectively restores speech and diet for most patients, improving quality of life.
Area of Science:
- Plastic Surgery
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
Background:
- Maxillary and midfacial bone defects after tumor resection cause significant functional and esthetic impairments, including oro-nasal communication and difficulties with speech and eating.
- Current reconstruction methods include prostheses, locoregional flaps, and free flaps, each with limitations.
Purpose of the Study:
- To evaluate the efficacy of combining anterolateral thigh free flaps with iliac crest or calvaria bone grafts for reconstructing extensive maxillary defects.
- To assess the functional (speech, diet) and esthetic outcomes of this combined reconstructive approach.
Main Methods:
- A retrospective study of eight patients who underwent maxillectomy with orbital content preservation and simultaneous reconstruction between November 2003 and June 2007.
- The reconstruction utilized anterolateral thigh free flaps coupled with iliac crest or calvaria bone grafts.
Main Results:
- All eight free flaps were successfully transplanted with no major complications; one patient experienced minor palatal dehiscence.
- Functional outcomes included normal or intelligible speech in seven patients and normal diets for six patients.
- Esthetic results were rated as good or acceptable by most patients, with minor issues in one case.
Conclusions:
- The combined use of anterolateral thigh free flaps and bone grafts is a reliable technique for complex maxillary defect reconstruction.
- This approach yields favorable functional and esthetic results, supporting its consideration for similar cases.