Abstract
Compared to reconstructive procedures in the mandible, bone and soft tissue reconstruction of the maxilla, the midface, and the cranial base often necessitates more complex surface reconstructions. In addition to functional restrictions, extensive defects in that area also lead to changes in the appearance of the patient as the zygomatic or maxillary complex provides the characteristic sagittal and transverse projection of a face [1]. The surgical strategies vary, depending on size and location of the defect. In contrast to the mandible, where significant functional loading also has to be taken into consideration, the biomechanical aspects of maxillary and midface reconstructions are of minor importance. Nevertheless, the multiform morphology of the maxilla and midface contributes to important functions such as deglutition, mastication, breathing, and speech. Complication rates of microvascular procedure in the upper face may be higher than in the lower oral cavity or mandible.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Coleman JJ. Microvascular approach to function and appearance of large orbital maxillary defects. Am J Surg. 1989;158:337–41.
Davis HW, Marshall MW. Effects of osseointegrated implant-supported prosthesis on bone preservation and regeneration in the edentulous mandible. In: Davis WM, Sailer H, editors. Oral and Maxillofacial Surgery Clinics of North America. Philadelphia: W.B. Saunders; 1994. p. 765–79.
Marx RE. Morbidity from bone harvest in major jaw reconstruction: a randomized trial comparing the lateral anterior and posterior approaches to the ilium. J Oral Maxillofac Surg. 1988;48:196–203.
Shapiro BM, Komisar A, Silver C, et al. Primary reconstruction of palatal defects. Otolaryngol Head Neck Surg. 1986;95:581–5.
Colmenero C, Martorell B, Colmenero B, et al. Temporalis myofacial flap for maxillofacial reconstruction. J Oral Maxillofac Surg. 1991;49:1067–73.
Kärcher H, Eskici A, Zwittnig P. Oberkieferrekonstruktion mit dem osteokutanen Skapulatransplantat nach Schußverletzung. Z Stomatol. 1988;85:371–7.
dos Santos LF. Le lambeau scapulaire et l’artere cutanee scapulaire. Paris: Laboratoire d’Anatomie de la Faculté de Médecine de Paris; 1980.
Nassif T, Vidal L, Bovet J, et al. The parascapular flap: a new cutaneous microsurgical free flap. Plast Reconstr Surg. 1982;69:591–600.
Pistner H, Reuther J, Bill J. Skapularegion als potentielles spenderareal für mikrochirurgische transplantate. In: Schwenzer N, Pfeifer G, editors. Fortschritte der kiefer-und gesichtschirurgie, vol. 35. Stuttgart: Thieme; 1990. p. 87–90.
Riediger D. Mikrochirurgische weichgewebetransplantation in die gesichtsregion. Munich: Hanser; 1983.
Imola MJ, Sciarretta V, Schramm VL. Skull base reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2003;11(4):282–90.
Moyer JS, Chepeha DB, Teknos TN. Contemporary skull base reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2004;12(4):294–499.
Califano J, Cordeiro PG, Disa JJ, Hidalgo DA, DuMornay W, Bilsky MH, et al. Anterior cranial base reconstruction using free tissue transfer: changing trends. Head Neck. 2003;25(2):89–96.
Chepeha DB, Wang SJ, Marentette LJ, Thompson BG, Prince ME, Teknos TN. Radial forearm free tissue transfer reduces complications in salvage skull base surgery. Otolaryngol Head Neck Surg. 2004;131(6):958–63.
Ermer MA, Gutwald R, Schumacher M, Schmelzeisen R, Taschner C. Use of the radial forearm artery for secondary embolization of an extensive life-threatening arteriovenous malformation of the mid-face and anterior skull base - a case report. J Craniomaxillofac Surg. 2013;41(3):258–64.
Hoffman HT, Jalowaysky AA, Robbins KT, et al. Oronasal reconstruction with local mucoperiosteal and free latissimus dorsi flaps. Arch Otolaryngol. 1992;118:1238–41.
Peters GE, Grotting JC. Free flap reconstruction of large head and neck defects in the elderly. Microsurgery. 1989;10:325–8.
Meyer H, Schmidt JW, Terrahe K, et al. Modifikation des mikrovaskular reanastomosierten latissimus dorsi lappens zur rekonstruktion nach erweiterter oberkieferresektion. NO. 1991;39:218–23.
Fisher J, Jackson IT. Microvascular surgery as an adjunct to craniomaxillofacial reconstruction. Br J Plast Surg. 1989;42:146–54.
Robson MC, Zachary LS, Schmidt DG, Faibisoff B, Hekmatpanah J. Reconstruction of large cranial defects in the presence of heavy radiation damage and infection utilizing tissue transferred by microvascular anastomoses. Plast Reconstr Surg. 1989;83(3):438–42.
Swartz WM, Banis JC, Newton ED, Ramasastry SS, Jones NF, Acland R. The osteocutaneous scapular flap for mandibular and maxillary reconstruction. Plast Reconstr Surg. 1986;77(4):530–45.
Posnick JC, Polley JW, Zuker RM, Chan HSL. Chemotherapy and surgical resection combined with immediate reconstruction in a 1-year-old child with rhabdomyosarcoma of the maxilla. Plast Reconstr Surg. 1992;89(2):320–5.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Science+Business Media, LLC, part of Springer Nature
About this chapter
Cite this chapter
Schmelzeisen, R., Albers, C., Voss, P.J. (2019). Microsurgical Reconstruction of Large Defects of the Maxilla, Midface, and Cranial Base. In: Greenberg, A., Schmelzeisen, R. (eds) Craniomaxillofacial Reconstructive and Corrective Bone Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1529-3_27
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1529-3_27
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-1528-6
Online ISBN: 978-1-4939-1529-3
eBook Packages: MedicineMedicine (R0)