Bioimplant a novel technique for planning microsurgical reconstruction of maxillary secondary defects after tumor ablation

Introduction: Several techniques have been developed to reconstruct maxillary defects following surgery, in order to restore function and cosmesis. Reconstruction of such defects provide support to the orbital contents, obliterate any communication between the orbit and nasopharynx, reconstruct the palatal surface, and achieve facial symmetry and a good aesthetic result. Consequently frequently unsatisfactory functional results, even in free vascularized flaps has motivated us to looking for a better solutions. Our presentation is a part of interdisciplinary team project—BioImplant supported by Polish Ministry of Education.

Patients and methods: We report our experience in performing reconstructive surgery on 2 patients who had a partial maxillectomy defects following ablative surgery. All patients were assessed preoperatively by CT. The scans allowed create stereolithographic (SLA) and virtual models for custom made Iliac crest free flaps for each patient. Intraoral vascular anastomoses were performed in each cases. Synths miniplates were used for intraoral fixation of bone flap.

Results: No reexplorations or free flap failures were observed. All patients had adequate functional vision. Speech was considered normal in both cases. Chewing function was considered good (soft to unrestricted diet) in all patients. Aesthetic results after immediate reconstruction were considered good.

Conclusions: Secondary reconstruction of total maxillectomy defects with orbital content preservation remains a complex problem without a perfect solution. The combination of virtual planning systems and nanotechnological bioactive scaffold grafts for maxillary reconstruction with a soft-tissue free flap in the future gives a safe, reliable, and effective method of maximizing postoperative functional and aesthetic results.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Bioimplant a novel technique for planning microsurgical reconstruction of maxillary secondary defects after tumor ablation
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