Purpose: In management of extensive maxillary defects, especially defects of piriform rim of nose, malar prominence and soft palate, it is difficult to provide a stable biomechanical frame for prosthesis while obturat...
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Purpose: In management of extensive maxillary defects, especially defects of piriform rim of nose, malar prominence and soft palate, it is difficult to provide a stable biomechanical frame for prosthesis while obturators are difficult to use。This study reviews our cases involving angular branch artery pedicled scapular bone flaps (SBF) combined with or without latissimus dorsi musculocutaneous flap (LDMF)。Methods: Between 2004 and 2007, three wide maxillary defects due tO tumor were repaired using the angular vascularized branch of the scapular bone。In three cases, we performed tumor resection with immediate reconstruction using combined LDMF and angular artery pedicled SBF (2 cases) and angular artery pedicled SBF alone (1 case)。The follow up was 6 months to 2 years。Facial appearance, speech, deglutition and nasal function were recorded。Results: Satisfactory results were obtained with facial contour and appearance, speech, deglutition and breathing。In all cases, neither donor site complications nor restricted shoulder movements were detected。Only one complication occurred in this series was a minor infection of one flap。Conclusions: This procedure is useful, both functionally and aesthetically for reconstruction of wide extensive maxillary defects as bone supplied by the angular branch which has a wider arc of rotation in relation to skin flaps and has a longer pedicle length fi'om the axillary artery long enough to reach the maxilla。Further, this procedure has flexibility of soft tissue pedicle, such as the latissimus dorsi, serratus anterior and fasciocutaneous flaps。
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