J Korean Assoc Maxillofac Plast Reconstr Surg.
2009 Mar;31(2):167-172.
A Clinical Case of Unilateral Maxillary Defect Reconstruction Using Nasolabial Flap
- Affiliations
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- 1Department of Oral & Maxillofacial Surgery, College of Medicine and Medical Research Institute, Chungbuk National University, Cheonju, Korea. ley926@chungbuk.ac.kr
Abstract
- The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis, viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature.
We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.