J Korean Cleft Palate-Craniofac Assoc.  2009 Apr;10(1):49-54.

Inferior Orbital Wall Reconstruction with Vascularized Partial Thickness Calvarial Bone Flap in Three Cases of Maxillary Tumor

• Shin SH
• Lee YJ
• Kim JS
• Kim NG
• Lee KS

Abstract

PURPOSE: Inevitably, Maxillary structural defect follows maxillary cancer extirpation. Maxillary reconstruction is over every surgeon's head. Every physician tried to overcome limited donor site of craniofacial defect. We considered to suggest optimal method of inferior orbital wall defect in functional point as well as esthetic point.
METHODS
We performed wide excision of maxilla and vascularized partial thickness calvarial bone flap to reconstruct the defect from cancer extirpation in three cases. We select ipsilateral superficial temporal artery, vein and outer cortex of parietal bone flap as donor. And we applied bone flap as inferior orbital wall structure. The bony surface was wrapped with fascia to prevent direct contact between orbital contents and rough bony flap surface. Computed tomography image was checked during follolw up period.
RESULTS
We can observe these patients for over two years. In all three cases, We can get fair inferior orbital wall structure. Even though they got radiation therapy, there was no limitation of extraocular movements, no diplopia. no enophthalmos. Also there was minimal donor site morbidity.
CONCLUSION
We suggest vascularized calvarial bone flap is practically excellent strategy for inferior orbital wall reconstruction

Keyword

Orbital wall reconstruction; Cranial bone graft; Calvarium; Superficial temporal artery

MeSH Terms

Diplopia
Enophthalmos
Fascia
Head
Humans
Maxilla
Orbit
Parietal Bone
Skull
Temporal Arteries
Tissue Donors
Veins