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Custom Presurgical Planning for Midfacial Reconstruction.

Nolan B Seim1, Enver Ozer1, Sasha Valentin2

  • 1Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Facial Plastic Surgery : FPS
|December 28, 2020
PubMed
Summary

Midface reconstruction presents surgical challenges due to complex anatomy and functional needs. A multidisciplinary approach and custom presurgical planning are crucial for optimal aesthetic and functional outcomes in head and neck oncology.

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Area of Science:

  • Head and Neck Surgery
  • Maxillofacial Prosthodontics
  • Oncology

Background:

  • Midface reconstruction is complex due to 3D anatomy, variable defects, and functional considerations (speech, swallowing, vision).
  • Challenges include anatomical complexity, defect variability, combined medical/dental needs, and limited access to reliable donor vessels for free tissue transfer.
  • Individual patient factors and unique resection defects necessitate tailored preoperative planning and reconstruction.

Purpose of the Study:

  • To present a planning and reconstructive algorithm for midface reconstruction.
  • To emphasize the importance of a multidisciplinary approach in managing midface defects.
  • To highlight a dedicated focus on dental rehabilitation through custom presurgical planning.

Main Methods:

  • Utilizing a multidisciplinary team approach involving reconstructive surgeons, prosthodontists, speech pathologists, oculoplastic surgeons, and dentists.
  • Implementing custom presurgical planning for each unique patient case.
  • Developing a structured algorithm for midface resection and reconstruction.

Main Results:

  • The presented algorithm facilitates tailored reconstruction addressing aesthetic and functional deficits.
  • Custom presurgical planning enhances the predictability and success of dental rehabilitation.
  • A multidisciplinary strategy optimizes long-term outcomes for speech, swallowing, and vision.

Conclusions:

  • Midface reconstruction demands a comprehensive, multidisciplinary strategy.
  • Custom presurgical planning is essential for successful dental rehabilitation and overall functional recovery.
  • The proposed algorithm provides a framework for managing complex midface defects effectively.