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Maxillo-Mandibular Reconstruction in Pediatric Patients: How To Do It?
Valentino Valentini1, Luigi Califano2, Andrea Cassoni1
1Odontostomatological Science and Maxillofacial Surgery Department, Sapienza University of Rome, Rome.
The Journal of Craniofacial Surgery
|February 14, 2018
Summary
Pediatric maxillo-mandibular reconstruction requires careful consideration of growth and function. Simultaneous reconstruction with tailored flap or graft selection, like rib grafts for young children, optimizes outcomes.
Area of Science:
- Craniofacial surgery
- Pediatric reconstructive surgery
Background:
- Maxillo-mandibular reconstruction in children presents unique challenges including craniofacial growth, dentition, symmetry, and donor site morbidity.
- Optimal timing and technique selection are crucial for functional and cosmetic success in pediatric patients.
Observation:
- This study reviews 25 pediatric cases to determine the best reconstructive strategies for maxilla-mandibular defects.
- Simultaneous resection and reconstruction is advocated.
- Local flaps are suitable for malignant maxillary defects; radiotherapy may be needed for large mandibular defects.
Findings:
- Free flaps are preferred for poor soft tissue conditions. Rib grafts are recommended for children under 5 without tissue damage.
- Titanium plates are best reserved for select cases, such as temporary reconstruction in toddlers.
Implications:
- Tailored reconstructive approaches considering age and defect type are essential for pediatric maxillo-mandibular reconstruction.
- Early, simultaneous reconstruction can improve long-term functional and aesthetic results in pediatric patients.
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