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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
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Scapular flap for maxillectomy defect reconstruction and preliminary results using three-dimensional modeling.

Mara C Modest1, Eric J Moore1, Kathryn M Van Abel1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.

The Laryngoscope
|October 13, 2016
PubMed
Summary

The thoracodorsal scapula composite free flap (TSCF) effectively reconstructs maxillary defects. Incorporating 3D models significantly improved aesthetic outcomes and surgical efficiency in reconstruction.

Keywords:
Scapula composite flapfree-flapmaxillectomy defectmicrovascular free-flapreconstructionscapula flapthree-dimensional modeling

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Area of Science:

  • Plastic Surgery
  • Maxillofacial Reconstruction
  • Biomedical Engineering

Background:

  • Maxillary defects pose complex reconstruction challenges, impacting function and aesthetics.
  • The thoracodorsal scapula composite free flap (TSCF) is a viable option for these defects.
  • Optimizing surgical techniques is crucial for patient satisfaction.

Purpose of the Study:

  • To evaluate current techniques for maxillary defect reconstruction using the scapular tip and subscapular system.
  • To assess the impact of three-dimensional (3D) modeling on TSCF reconstruction outcomes.
  • To analyze surgical, functional, and aesthetic results in a case series.

Main Methods:

  • A case review of patients undergoing maxillectomy and TSCF reconstruction.
  • Inclusion of 3D models for intraoperative planning in the latter five cases.
  • Review of surgical, functional, and aesthetic outcomes, with a median follow-up of 5.2 months.

Main Results:

  • Nine patients underwent TSCF reconstruction for various maxillectomy defects.
  • 3D modeling enhanced intraoperative efficiency, contouring, and flap inset.
  • Aesthetic outcomes were superior in the 3D modeling group (100% vs. 50%), with no flap failures.

Conclusions:

  • The TSCF is a versatile flap for maxillary reconstruction, with laterality selection being key.
  • Internally produced 3D models refine intraoperative planning and flap placement.
  • 3D modeling leads to more successful aesthetic and functional outcomes in TSCF reconstructions.