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Reconstruction of a Compound Oromandibular Defect by Means of Chimeric Scapular-Parascapular Free Flap Assisted by Virtual Surgical Planning
- Source :
- The Journal of craniofacial surgery. 29(3)
- Publication Year :
- 2018
-
Abstract
- BACKGROUND Reconstruction of an oromandibular defect presents a considerable surgical challenge. But since the advent of microvascularized free flap reconstructive surgery, outcomes have improved significantly so that today almost any defect may be reconstructed. Recently, virtual surgical planning has reduced surgical time, the morbidity associated with surgery, and surgical precision. OBJECTIVE This article reports a complex patient with a composite oromandibular defect. METHODS The patient had undergone multiple surgeries with bad results. She presented an orostoma of 5 cm in diameter, osteoradionecrosis and fracture of the left mandibular body, and relapse in the ipsilateral posterior maxilla. Reconstruction was performed by means of a scapular/parascapular chimeric free flap. A customized reconstruction plate was designed virtually based on the mirror image of the contralateral mandibular body. Surgery and the postoperative phase passed without incident. The patient recovered vocal, swallowing, and respiratory function without any problems. At the end of a 1-year follow-up, no complications or tumor relapse had occurred. CONCLUSIONS Composite defects are a surgical challenge in which free flap reconstruction is an evolution that has facilitated treatment and led to improved outcomes. Virtual treatment planning produces more exact results and greater control of surgical techniques.
- Subjects :
- medicine.medical_specialty
Reconstructive surgery
Osteoradionecrosis
Free flap
Mandible
Surgical planning
Free Tissue Flaps
03 medical and health sciences
0302 clinical medicine
Mandibular body
Swallowing
Medicine
Humans
Respiratory function
Radiation treatment planning
Aged
business.industry
030206 dentistry
General Medicine
Plastic Surgery Procedures
medicine.disease
Surgery
Scapula
Otorhinolaryngology
Surgery, Computer-Assisted
030220 oncology & carcinogenesis
Female
business
Jaw Diseases
Subjects
Details
- ISSN :
- 15363732
- Volume :
- 29
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The Journal of craniofacial surgery
- Accession number :
- edsair.doi.dedup.....bb29883768c1c2bd6fb932b3826b885a