Repair of composite zygomatico-maxillary defects with free bone grafts and free vascularized tissue transfer.
BACKGROUND
Three-dimensional repair of the zygomatico-maxillary defect calls for an elaborate technique to achieve facial symmetry and correct globe position. We present a technique, which combines the use of a free vascularized soft tissue flap and free bone grafts for repair of composite zygomatico-maxillary defects.


METHODS
Three patients that underwent radical resection of the maxilla and the zygoma have undergone facial reconstruction using this technique. The mean follow up was 9 months.


METHODS
The key points of this technique are: (1) precise reconstruction of the zygomatico-maxillary complex including the orbit; (2) creation of a skeletal framework for canthopexy and suspension of the free flap; (3) repair of through-and-through soft tissue defects with a folded musculocutaneous free flap; and (4) simultaneous harvesting and reconstruction using two surgical teams to reduce the duration of surgery.


RESULTS
Reconstruction of the zygomatico-maxillary complex could be successfully accomplished in a single surgical procedure.


CONCLUSIONS
This paper presents a method of repairing zygomatico-maxillary defects with free bone grafts and vascularized soft tissue. However, this concept has yet to be reviewed in the long term.
Rohner
D
D
Department of Plastic Surgery, Singapore General Hospital, Singapore. dennisrohner@hotmail.com
Tan
B K
BK
Song
C
C
Yeow
V
V
Hammer
B
B
D000368:Aged; D016025:Bone Transplantation / Q000379:methods; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002610:Cheek / Q000601:surgery; D005143:Eyelids / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery; D009061:Mouth Mucosa / Q000601:surgery; D018482:Muscle, Skeletal / Q000637:transplantation*; D009361:Neoplasm Invasiveness; D009915:Orbit / Q000601:surgery; D012512:Sarcoma, Ewing / Q000601:surgery; D016038:Skin Transplantation / Q000379:methods; D012888:Skull Neoplasms / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply; D013997:Time Factors; D015050:Zygoma / Q000601:surgery*