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    Evolution of midface microvascular reconstruction: three decades of experience from a single institution

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    Authors
    Vedran, U.
    Kavit, A.
    Igor, B.
    Damir, K.
    Issue Date
    2022
    
    Metadata
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    Abstract
    Purpose Midface reconstruction poses a complex set of challenges for reconstructive surgeons. The optimal midface reconstruction must possess a durable underlying bone construct capable of integrating dental implants. Facial contour is restored by the overlying microvascular soft tissue reconstruction with reestablishment of the oral cavity. A plethora of microvascular flaps used in clinical practice have been described including those harvested from the iliac crest, scapula, fibula, forearm and back (latissimus dorsi). The objective was to share our experiences with each of these treatment options that have continued to evolve over time for the benefit of patients. Methods Our institution has over three decades of experience in reconstructing complex midface defects and this article summarizes midface reconstruction from an evolutionary perspective (for type II, III and IV defect; Browns classification, Supplementary Table I). We broadly divide this into (i) flaps supplied by the subscapular system (ii) autologous reconstruction with titanium mesh and (iii) fibula microvascular flaps using 3D planning. Results The advantages and disadvantages for each approach are discussed (Supplementary Table II). Conclusion In the future, it is expected that 3D planning coupled with rapid prototyping, intraoperative navigation and CT imaging will become standard procedural practice.
    Citation
    Vedran U, Kavit A, Igor B, Damir K. Evolution of midface microvascular reconstruction: three decades of experience from a single institution. European Archives of Oto-Rhino-Laryngology. Springer Science and Business Media LLC; 2022.
    Journal
    European Archives of Oto-Rhino-Laryngology
    URI
    http://hdl.handle.net/10541/625163
    DOI
    10.1007/s00405-022-07321-x
    PubMed ID
    35316380
    Additional Links
    https://dx.doi.org/10.1007/s00405-022-07321-x
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00405-022-07321-x
    Scopus Count
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