Jaw in a Day: State of the Art in Maxillary Reconstruction. Issue 8 (November 2016)

• Record Type: Journal Article
• Authors: Runyan, Christopher M.; Sharma, Vishal; Staffenberg, David A.; Levine, Jamie P.; Brecht, Lawrence E.; Wexler, Leonard H.; Hirsch, David L.
• Is Part Of: Journal of craniofacial surgery. Volume 27:Issue 8(2016)
• Publication Date: 2016-11
• Subjects: Computer-aided surgical planning -- Ewing sarcoma -- free fibula flap -- LeFort I -- osseointegrated implants; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000003139
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Background: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. Methods: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality. Her reconstruction was computer-simulated by a multidisciplinary team, consisting of left hemi-Lefort I advancement and right maxillary reconstruction with a free fibula flap with immediate osseointegrated implants and dental prosthesis. Results: Full dental restoration, midface projection, and oral fistula corrections were achieved in 1 operative stage using this approach. Conclusions: This patient demonstrates a successful approach for maxillary reconstruction using computer-planned orthognathic surgery with free fibula reconstruction and immediate osseointegrated implants with dental prosthesis.