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Palatal flap in bilateral inferior partial maxillectomy.

Daniel Sathiya Sundaram Selvaraj1, Pranay Gaikwad2, Jagadish Ebenezer3

  • 1Department of Dental and Oral Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India danielvellore@gmail.com.

BMJ Case Reports
|March 17, 2021
PubMed
Summary

This study presents a novel palatal flap technique for maxillectomy reconstruction. Preserving the descending palatine artery successfully separates oral and nasal cavities, avoiding obturators.

Keywords:
bone and joint infectionsdentistry and oral medicinehead and neck surgeryoral and maxillofacial surgeryotolaryngology / ENT

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Head and Neck Oncology

Background:

  • Maxillectomy is a surgical procedure to remove part or all of the upper jaw.
  • Reconstruction after maxillectomy aims to restore form and function, including separating the oral and nasal cavities.
  • Current methods often require obturators or additional flaps.

Purpose of the Study:

  • To describe a technique for separating the oral and nasal cavities following bilateral inferior partial maxillectomy.
  • To evaluate the use of a palatal flap preserving the descending palatine artery for this separation.
  • To eliminate the need for obturators or secondary flaps in reconstruction.

Main Methods:

  • Bilateral inferior partial maxillectomy was performed.
  • A palatal flap was designed and elevated while preserving the descending palatine artery.
  • The flap was utilized to reconstruct the defect and separate the oral and nasal cavities.

Main Results:

  • The described technique successfully separated the nasal cavity from the oral cavity.
  • The descending palatine artery preservation ensured flap viability.
  • This method obviated the need for an obturator or other reconstructive flaps.

Conclusions:

  • Preserving the descending palatine artery allows for the use of a palatal flap in maxillectomy reconstruction.
  • This technique provides an effective method for separating the oral and nasal cavities.
  • It offers a simpler, single-stage solution compared to traditional methods.