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Vascularized bone graft is a better option for the reconstruction of maxillary defects

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

We read the article of Kinnunen et al., which evaluated the result of maxillary defects, and feel some objections. We present our considerations of their operative indication and thoughts based on our surgical experiences. Defects after palatectomy, which have left no dentition for the retention of an obturator, require vascularized bone-containing free flaps. Local flaps are available in only small defects of Class 1 and 2a. Most palatomaxillary defects following malignant tumor abrasion are classified as 2b, 2c, 3, or 4, which require microsurgical free flap transfer combined with bony reconstruction. Regarding bony reconstruction, non-vascularized bone grafts tend to be absorbed. Thus, we believe that bony reconstruction should be performed with vascularized bone. We agree with the authors’ comment that PTMF may be useful in repairing defects due to complications in microvascular procedures in the palatal area. However, even when bone segment is required for salvage surgery, using a vascularized bone flap is more preferable. A parietal bone-fascial-periosteal flap based on the superficial temporal vessels is a suitable and reliable bone flap for the reconstruction of a maxillary defect following free skin flap transfer to the palate.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Nagasaki University, Nagasaki, Japan

    Masaki Fujioka

  2. Department of Plastic and Reconstructive Surgery, Clinical Research Center, National Hospital Organization Nagasaki Medical Center, 1001-1 Kubara 2, Ohmura City, Nagasaki, 856-8562, Japan

    Masaki Fujioka

  3. Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan

    Kenji Hayashida & Chikako Murakami

Authors
  1. Masaki Fujioka
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  2. Kenji Hayashida
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  3. Chikako Murakami
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Correspondence to Masaki Fujioka.

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Fujioka, M., Hayashida, K. & Murakami, C. Vascularized bone graft is a better option for the reconstruction of maxillary defects. Eur Arch Otorhinolaryngol 270, 2779–2781 (2013). https://doi.org/10.1007/s00405-013-2619-5

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  • DOI: https://doi.org/10.1007/s00405-013-2619-5

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