Pedicle Orientation in Free-Flap Microvascular Maxillofacial Reconstruction

Daniel M. Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral–nasal and oral–antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. The free fibula microvascular osteocutaneous flap has proved the workhorse of these maxillary and mandibular reconstructions. The success of microvascular reconstruction often hinges on flap viability in the immediate postoperative period. With most flap failures attributed to vascular compromise resulting from clot formation and venous congestion, uncompressed, and nontortuous pedicle positioning demands surgical attention. Although the use of the free fibula flap in maxillary reconstruction is a well-described and predictable procedure, the specifics of the flap inset with respect to pedicle positioning and technique within the maxilla and neck have not been clearly detailed in the available studies. In the present technique note, we have provided our surgical description for pedicle positioning and anatomic alterations in an attempt to improve microvascular anastomosis flap success.

Original languageEnglish (US)
Pages (from-to)875.e1-875.e4
JournalJournal of Oral and Maxillofacial Surgery
Volume75
Issue number4
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

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