Immediate microvascular reconstruction of combined palatal and midfacial defects.
We describe a method for immediate one-stage reconstruction of combined palatal and midfacial defects using latissimus dorsi musculocutaneous free-tissue transfer. It has consistently provided healed wounds, restoration of palatal function, and preservation of facial contour while obviating the need for a palatal prosthesis. This reconstructive method, which uses only autogenous tissue, may offer a significant advantage in cases where more than a hemimaxillectomy is required, for compound defects resulting from the sacrifice of facial structures along with the maxillectomy, and in situations where the resection involves cranial base structures with a resultant need to separate the cranial contents from the oral and nasal cavities. Finally, it provides an alternative to prosthetic rehabilitation for the elderly patient with decreased or absent vision.
Shestak
K C
KC
Division of Plastic and Reconstructive Surgery, University of Pittsburgh, Pennsylvania 15261.
Schusterman
M A
MA
Jones
N F
NF
Janecka
I P
IP
Sekhar
L N
LN
Johnson
J T
JT
D005153:Facial Neoplasms / Q000601:surgery*; D006801:Humans; D008441:Maxillary Neoplasms / Q000601:surgery*; D010157:Palatal Neoplasms / Q000601:surgery*; D013518:Surgery, Plastic; D013524:Surgical Flaps