Background and objectives: Patients with maxillary atrophy after multiple surgical attempts or oro-nasal communications after maxillectomy remain a challenge for adequate reconstruction and dental rehabilitation. A new palatal flap design is used for maxillary reconstruction.
Methods: Based on the anterior palatine arteries and veins; the palatal soft tissues are elevated underneath the periosteum, a through and through incision is made on the palatine bone across the palate, the elevated flap is only attached to the vessels, which are meticulously elongated to allow better mobilization. The palatal unit could be rotated or advanced and fixated first with screws to the bone and then multiple individual sutures. Data is based on 10 patients, ages 39.5 (32–65) were treated for maxillary reconstruction, four underwent immediate anterior maxillary bone grafting and dental implants placement and six for oro-nasal closure and zygoma fixtures insertion after partial maxillectomy.
Results: Implants were inserted either in grafts for the anterior reconstructions or zygoma implants in the posterior maxillary reconstruction. No implants were lost.
Conclusions: Palatal flap unit allows avoids the need for temporal muscle flaps or microvascular grafts. Ideal cosmetic and functional results were obtained with dental rehabilitation.
Key words : palatal flap; maxillary reconstruction; zygoma implant.