Vastus lateralis muscle flap used for reconstruction of the maxilla after radical resection of recurrent ameloblastoma.
Maxillary ameloblastoma is a benign odontogenic neoplasm. Excision should involve wide margins because of its high recurrence rate and, ideally, be followed by reconstruction. A 23 year-old female patient presented with recurrent ameloblastoma. Two years previously, she had undergone a curettage excision. The recurrent lesion was managed by a total maxillectomy including inferior orbital rim. Simultaneous reconstruction was performed with an iliac crest bone graft for the orbital floor, and a vastus lateralis muscle flap for obliteration of the maxillary sinus and repair the oral and nasal cavities. The transferred vastus lateralis muscle already had spontaneous mucosalization over its surface two weeks after surgery. Postoperative follow up after fourteen months revealed no recurrence and no diplopia. The patient was satisfied with her appearance. The use of a single vastus lateralis muscle flap to repair both oral and nasal cavities is advantageous. It helps avoid hyper-nasal speech and maintain the stability of removable partial dentures. The conventional iliac bone graft supported by a well vascularized muscle eventually survived and provided a good functional and cosmetic result.
Tsai
Chi-Ying
CY
Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Wei
Fu-Chan
FC
Chang
Yu-Liang
YL
Chen
Ya-Yi
YY
Chen
Chien-Tzung
CT
D000328:Adult; D000564:Ameloblastoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps