Two-subunit-osteotomy approach of vascularized iliac-internal oblique muscle composite flap in total maxillary reconstruction

Abstract

Abstract: PURPOSE: Through three dimensional measurement and analysis of normal adult maxilla, to delineate maxillary morphological features and regularities which can be applied to conduct osteotomy of iliac bone and reconstruction of total maxillary defect. METHODS: A total of 40 normal maxillary CT data (Dicom format) were collected and delivered to Proplan CMF 2.0. The real-size maxillary model was established on which 6 anatomic bony marks were set up and 7 maxillary contour variables (including 6 linear and 1 angular items) were measured. The data were analyzed using SPSS 19.0 software package. A female patient with total maxillary defect underwent maxillary reconstruction with vascularized iliac composite flap in two-subunit-osteotomy approach was presented. RESULTS: The coefficience variation of maxillary linear variables was greater than that of angular variable. The contour of maxilla could be divided into two subunits of paranasal region and infraorbital region though a line segment from nasion to distal alveolar crest of maxillary second premolar. The anterior intersection angle (δ) between the two subunits was 150° with no significant sex and individual differences (P=0.1527, CV=2.74%). Two-subunit-osteotomy approach was clinically applied to shape the iliac bone into paranasal triangular segment and infraorbital quadrangular segment to reconstruct total maxillary defect, which achieved excellent cosmetic subunit. CONCLUSION: Two-subunit-osteotomy approach of vascularized iliac composite flap can rapidly and accurately reconstruct total maxillary defect and achieve excellent cosmetic and functional results.

Key words: Total maxillary reconstruction, Iliac-internal oblique muscle flap, Maxillary morphology

CLC Number:

R782.2

YU Miao, WANG Hui-shan, HAN Jing, HU Long-wei, LIU Jian-nan, WANG Yang, ZHANG Chen-ping, XU Li-qun. Two-subunit-osteotomy approach of vascularized iliac-internal oblique muscle composite flap in total maxillary reconstruction[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(5): 430-434.

References

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