Principles of Orofacial Reconstruction
Principles of Orofacial Reconstruction
Principles of Orofacial Reconstruction
OROFACIAL
RECONSTRUCTION
Introduction
• Two choices
a)Delayed: wait a period of time post-ablation and
then return patient to OR for reconstruction(usu. 6
months) Radiation, scarring, contracture, muscle
atrophy, increased hospitalization, poor cosmesis and
fibrosis can contribute to a suboptimal result
–6-12 months or longer
–Looks bad
–Fibrosis means you ultimately don’t get good bony
union or heal
• This is a poor concept
TIMING OF RECONSTRUCTION
• Small areas of skin grafts are best harvested from the upper
arm: in younger patients from the inner aspect, and in older
thin skinned patients from the outer aspect.
b-Myocutaneous
Trapezius (Transverse cervical artery)
Temporalis (superficial temporal artery)
Sternocliedomastoid Muscle (occipital, superior
thyroid)
c-Osseomyocutaneous
Pectoralis major
Trapezius
5. Free flaps with microvascular re-anastomosis
• Most commonly used for mandibular defects in the head and neck
• best for angle/body defects
• can be used for symphyseal and parasymphyseal defects
Bone graft
Autogenous graft