Reconstruction of partial maxillectomy defect with a buccal fat pad flap and application of 4-hexylresorcinol: a case report

BackgroundSquamous cell carcinoma (SCC) is the most commonly occurring malignant tumor in the oral cavity. In South Korea, it occurs most frequently in the mandible, tongue, maxilla, buccal mucosa, other areas of the oral cavity, and lips. Radial forearm free flap (RFFF) is the most widely used reconstruction method for the buccal mucosal defect. The scar of the forearm donor, however, is highly visible and unsightly, and a secondary surgical site is needed when such technique is applied. For these reasons, buccal fat pad (BFP) flap has been commonly used for closing post-surgical excision sites since the recent decades because of its reliability, ease of harvest, and low complication rate.Case presentationIn the case reported herein, BFP flap was used to reconstruct a cheek mucosal defect after excision. The defect was completely covered by the BFP flap, without any complications.ConclusionDiscussed herein is the usefulness of BFP flap for the repair of the cheek mucosal defect. Also, further studies are needed to determine the possibility of using BFP flap when the defect is deep, and the maximum volume that can be harvested considering the changes in volume with age.

Section: Introductionmentioning

confidence: 99%

Reconstruction of cheek mucosal defect with a buccal fat pad flap in a squamous cell carcinoma patient: a case report and literature review

Hwang

Park

Kim

et al. 2018

“…The temporalis muscle is the workhorse for repairing such defects, while buccal fat pad has room in case of minor oronasal/antral communications [14]. When needed, adequate bone support may be set by secondary bone grafting.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, local and regional flaps are less demanding, but their use is restricted to more limited palato-alveolar defects (up to the midline). The temporalis muscle is the workhorse for repairing such defects, while buccal fat pad has room in case of minor oronasal/antral communications [ 14 ]. When needed, adequate bone support may be set by secondary bone grafting.…”

Section: Case Presentationmentioning

confidence: 99%

Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases

Salvatori¹,

Mincione

Rizzi

et al. 2017

BackgroundOronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator.The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort.Cases presentationWe report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation.ConclusionsAll surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

“…The reconstruction of complex cranio-maxillofacial defects is challenging due to the unique anatomy, the presence of a vital structure, and the variety of deficits [ 1 , 2 ]. The reconstruction of congenital or acquired cranio-maxillofacial defects due to congenital abnormalities, post-trauma, tumor resection, and infection requires both functional and esthetic considerations [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…With the development of CAD/CAM technology, there have been increasing cases of restructuring cranio-maxillofacial defects to improve appearance and function with more accurate surgery and shorter operation times [ 8 ]. With CAD/CAM software, accurate pre-operative planning can be established, and surgeons can perform virtual ablation, plan osteotomy and reconstruction procedures, or create patient-specific implants (PSIs) [ 3 , 4 , 9 ] (Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing

2018

With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.