title: Total Maxillary Reconstruction With a Bi-Paddle Double-Barrel Osteocutaneous Fibular Flap and Arteriovenous Saphenous Loop After a Globe-Sparing Total Maxillectomy Due to Osteosarcoma.
abstract: BACKGROUND
  The titanium mesh or bone graft is usually used for orbital support after a globe-sparing total maxillectomy. However, its use can invite complications, such as infection, exposure, and absorption, especially for patients who require adjuvant radiotherapy. Here, the authors present a patient who received total maxillary reconstruction with an osteocutaneous fibular flap.
  
  
  METHODS
  A 53-year-old man with the diagnosis of maxillary osteosarcoma received a globe-sparing total maxillectomy. A bi-paddle double-barrel osteocutaneous fibular flap was used for orbital support, alveolar ridge recreation, and oro-sino-nasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap was overcome by creating an arteriovenous saphenous loop.
  
  
  RESULTS
  The postoperative recovery was uneventful. During the 9 months follow-up, the patient was tumor-free and satisfied with his appearance, speech, and intake functions.
  
  
  CONCLUSIONS
  Reconstruction with a bi-paddle double-barrel osteocutaneous fibular flap after a globe-sparing total maxillectomy can achieve satisfactory aesthetic and functional results.
authors.affiliation: *Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University †Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Wan-Ling
authors.initials: WL
authors.lastname: Tseng
authors.forename: Tzu-Yen
authors.initials: TY
authors.lastname: Chang
authors.forename: Kuo-Shu
authors.initials: KS
authors.lastname: Hung
authors.forename: Szu-Han
authors.initials: SH
authors.lastname: Chen
authors.forename: Jenn-Ren
authors.initials: JR
authors.lastname: Hsiao
authors.forename: Yao-Chou
authors.initials: YC
authors.lastname: Lee
mesh_terms: D001163:Arteriovenous Anastomosis; D016025:Bone Transplantation / Q000379:methods*; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D012516:Osteosarcoma / Q000175:diagnosis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012501:Saphenous Vein / Q000601:surgery*; D013524:Surgical Flaps