Korean J Otolaryngol-Head Neck Surg.  1998 Dec;41(12):1625-1632.

Rectus Abdominis Free Flap Reconstruction for Orbital-Maxillary Defect in Advanced Maxillary Sinus Cancer

• Koh JW
• Kim HJ
• Oh JH
• Kim BC

Abstract

In the management of advanced maxillary sinus cancer, sometimes it requires an extensive ablation and orbital exenteration that results in large and full defects of the cheek and orbital regions. Reconstruction of large orbital-maxillary defects can be accomplished in one stage by microsurgical free transfer of rectus abdominis myocutaneous flap. The muscle component is suitable to fill the orbital and maxillary cavities, and the skin components are used for cheek, palate and lateral nasal cavity wall reconstruction as a three-dimentional folded free flap. Major problems with this flap are the bulkiness, the possibility of abdominal hernia and muscle weakness following the removal of the rectus abdominis muscle. Free deep inferior epigastric artery skin flap without rectus abdominis muscle is available in the reconstruction of large orbital-maxillary defect without the problems of the rectus abdominis myocutaneous free flap. We experienced one case of rectus abdominis myocutaneous free flap, and one other case of inferior rectus abdominis free flap for the reconstruction of huge surgical defects due to radical maxillectomy with orbital excenteration. Both of the patients were satisfied and there have been no severe complication associated with these technique.

Keyword

Orbital-maxillary defects; Rectus abdominis myocutaneous free flap; Inferior rectus abdominis free flap; Three-dimensional folded free flap

MeSH Terms

Cheek
Epigastric Arteries
Free Tissue Flaps*
Hernia, Abdominal
Humans
Maxillary Sinus Neoplasms*
Maxillary Sinus*
Muscle Weakness
Myocutaneous Flap
Nasal Cavity
Orbit
Palate
Rectus Abdominis*
Skin