Osseous reconstruction of the midface and orbits

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Reconstructive Surgery

Background:

• The orbitonasomaxillary complex is a critical three-dimensional structure vital for function and aesthetics.
• Reconstruction of midface defects from malignancy, congenital issues, or trauma presents significant anatomical challenges.
• Proper bone replacement in the functional anatomic position is essential for successful outcomes.

Purpose of the Study:

• To review reconstructive techniques for complex midface and orbitonasomaxillary defects.
• To highlight the role of vascularized bone and free tissue transfer in bony reconstruction.
• To emphasize the importance of functional and anatomical restoration.

Main Methods:

• Review of reconstructive principles for midface bony defects.
• Discussion of free bone grafts and their limitations.
• Evaluation of vascularized bone transfer via temporoparietal fascial flap and free tissue transfer.

Main Results:

• Free bone grafts necessitate well-vascularized beds and may require prior soft-tissue reconstruction.
• Vascularized bone transfer and free tissue transfer are effective for replacing bony components in complex defects.
• Existing free tissue transfer techniques can be adapted to specific defect requirements.

Conclusions:

• Successful reconstruction of the orbitonasomaxillary complex demands meticulous attention to functional anatomy.
• Vascularized bone and free tissue transfer provide robust options for addressing complex bony defects.
• Customization of free tissue transfer techniques optimizes results for diverse reconstructive needs.