title: Maxillary reconstruction using a free deep inferior epigastric perforator (DIEP) flap combined with vascularised costal cartilages.
abstract: In this article, we describe a case of maxillary carcinoma requiring reconstruction in which we used a free deep inferior epigastric perforator (DIEP) flap combined with vascularised costal cartilages. The DIEP flap was harvested with a rectus abdominis muscle in its cranial side. Eighth and ninth costal cartilages were harvested and connected with the muscle. The Zygomaticomaxillary buttress was reconstructed using vascularised costal cartilages. Nasal and oral lining were reconstructed with a DIEP flap. The viability of grafted bone was proved in bone scintigraphy and three-dimensional computed tomography after six months. Cosmetically the result was good. Compared with other methods, this flap can be thinned easily to match a defect and vascularised cartilages connected with rectus muscle can be nourished by the same vascular pedicle. This is a first report of perforator flap combined with vascularised cartilage. This flap has a possibility to be used for a lot of reconstruction that needs bone reconstruction with perforator flap.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo 060-0012, Hokkaido, Japan. msekido@med.hokudai.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sekido
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shujiroh
authors.initials: S
authors.lastname: Makino
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002356:Cartilage / Q000098:blood supply / Q000637:transplantation*; D019074:Epigastric Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*