| 상악결손부의 2차적 재건에 있어 유리 혈관화 피판의 적용 |
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권대근1, 김진수2 |
1경북대학교 치의학 전문대학원, 구강악안면외과학교실
2경북대학교 치의학 전문대학원, 구강악안면외과학교실 |
| Late reconstruction of oncological maxillary defect with microvascular free flap |
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Tae-Geon Kwon1, Chin-Soo Kim2 |
1Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University
2Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University |
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| Abstract |
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Microvascular reconstruction of maxillary composite defect after oncologic resection has improved both esthetic and functional aspect of quality of life of the cancer patients. However, a lot of patients had prior surgery with radiation and/or chemotherapy as a part of comprehensive cancer treatment. Sometimes it is nearly impossible to find out adequate recipient vessel for maxillary reconstruction with microvascular anastomosis. Therefore long pedicle of the flap is needed to use distant neck vessels located far from the reconstruction site such as ipsilateral transverse cervical artery or a branch of contralateral external carotid artery. For this reason, although we know the treatment of the choice is osteocutaneous flap, it is difficult to use this flap when we need long pedicle with complex three dimensional osseous defect. Vascular option for these vessel-depleted neck patients can be managed by a soft tissue reconstruction with long vascular pedicle and additional free non-vascularized flap that is rigidly fixed to remaining skeletal structures. For this reason, maxillofacial reconstruction by vascularized soft tissue flap with or without the secondary restoration of maxillary bone with non-vascularized iliac bone can be regarded as one of options for reconstruction of profound maxillofacial composite defect resulted from previous oncological resection with chemo-radiotherapy. |
| Key Words:
maxillfoacial reconstruction;free flap;vessel-depleted neck;composite defect; |
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