A Case Report of Maxillary Reconstruction by Using Vascularized Calvarial Bone and Free Rectus Abdominis Myocutaneous Flap

Lee, Choong Jae; Kim, Joong Kyeong; Lee, Se ll

Abstract

Total maxillectomy usually results in defects on anterior, posterior, medial and lateral wall of the maxilla besides the palate and the orbit floor. The traditional reconstructive approaches to maxillectomy include skin grafting to line the internal cavity and palatal prosthesis to obturate the palate and serve as a denture. This method is easy to detect tumor recurrence by direct examination. The drawback of this method is that the infection rate is very high and it can not yield structural support to the upper midface. It is not possible to repair the maxillary defects effectively when using only the hard tissue like bone. The reconstruction by using soft tissue makes it possible to repair the defects on the medial nasal wall, eye socket and the palate, but it is impossible to reconstruct the malar eminence. Therefore, the transfer of soft and hard tissue is recommended for the ideal and effective reconstruction of the defect after the total maxillectomy. We have acquired satisfactory results for both fuctional and aesthetical purposes in the cancer patient who received the maxillectomy by using the vascularized calvarial bone and the free rectus abdominis myocutaneous flap.