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Advances in midface reconstruction: beyond the reconstructive ladder.
Antoine Eskander1, Stephen Y Kang, Theodoros N Teknos
1Department of Otolaryngology - Head & Neck Surgery, Division of Head & Neck Oncology, Ohio State University, James Cancer Centre and Solove Research Institute, Columbus, Ohio, USA.
Summary
Midface reconstruction involves complex techniques for unique defects. Recent advancements in free flap and dental rehabilitation methods enhance surgical outcomes for challenging cases.
Area of Science:
- Plastic Surgery
- Oral and Maxillofacial Surgery
- Anatomy
Background:
- The midface and maxilla are critical anatomical structures.
- Defects in this region present unique reconstructive challenges.
- Numerous classification systems exist, yet individualized approaches are essential.
Purpose of the Study:
- To review the anatomy and function of the midface.
- To discuss defect classifications.
- To explore common and novel reconstructive techniques.
Main Methods:
- Review of existing literature on midface reconstruction.
- Analysis of various reconstructive techniques, including flaps and dental rehabilitation.
- Evaluation of advancements in medical modeling and surgical guides.
Main Results:
- Regional pedicled flaps with bone are increasingly utilized.
- Modified free flaps (radial forearm, fibula) improve osseointegrated implant success.
- Scapular free flap offers versatility and good bony contour match.
- Dental splints are cost-effective adjuncts to medical modeling.
Conclusions:
- Midface reconstruction is a complex surgical field.
- A variety of classification systems and techniques are available.
- Recent developments continue to improve reconstructive strategies.
