Principles of Reconstruction: Palatomaxillary Reconstruction

  • Cesare PiazzaEmail author
  • Alberto Paderno
  • Piero Nicolai


Minor salivary gland tumours frequently arise from the hard palate and maxillary sinus. Both resection and reconstruction of these structures are particularly challenging in consideration of their essential aesthetic and functional roles. Concerning reconstruction, the main objectives are to reconstitute the palatal and midfacial structural framework, withstanding the forces applied during mastication, to provide adequate separation between the oral cavity and nasal fossa/residual maxillary sinus and to grant a symmetric facial appearance. A number of reconstructive approaches may be applied in this diverse group of defects, ranging from obturator prostheses and local flaps to more complex techniques such as free fascio-cutaneous and/or bone-containing flaps. In this view, it is essential to precisely define the type of defect according to its “horizontal” extension at the level of the hard palate and its “vertical” extent in the midface, orbit and skull base. In this chapter, the most frequently adopted reconstructive choices will be presented and described, detailing their main indications, advantages and downsides.


Reconstruction Resection Palatomaxillary Maxillectomy Minor salivary glands Local flap Pedicled flap Free flap 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Maxillofacial and Thyroid SurgeryFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  2. 2.Department of Otorhinolaryngology—Head and Neck SurgerySpedali Civili of Brescia, University of BresciaBresciaItaly

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