Search Results (4)

Study Design: Narrative review. Objective: To describe the advantages, challenges, and potential indications of the submental artery island flap as a local pedicled flap for head and neck reconstruction. Methods: We conducted a comprehensive review of the literature to describe the submental artery island flap’s surgical technique, indications, and outcomes. Data sources included peer-reviewed articles, case reports, and clinical studies on using the submental flap in head and neck surgery reconstruction. Results: The submental artery island flap, while offering advantages such as minimal donor site morbidity, and good cosmetic outcomes, presents challenges related to the pedicle dissection and patient selection. This flap is particularly suitable for defects in the oral cavity, oropharynx, parotid bed, and midface or neck skin. Simultaneous neck dissection is feasible but should be approached with caution in patients with a history of prior neck surgery. Conclusions: The submental artery island flap is a valuable option for selected cases. When performed in the right patient with a correct technique, this flap can reconstruct defects in the oral cavity, oropharynx, parotid bed, and skin of the midface or neck with a minimally visible scar of the donor site. Full article

Background: The reconstruction of midface skin defects represents a challenge for the head and neck surgeon due to the midface’s significant role in defining important facial traits. Due to the high complexity of the midface region, there is no possibility to use one definitive flap for all purposes. For moderate defects, the most common reconstructive techniques are represented by regional flaps. These flaps can be defined as donor tissue with a pedunculated axial blood supply not necessarily adjacent to the defect. The aim of this study is to highlight the more common surgical techniques adopted for midface reconstruction, providing a focus on each technique with its description and indications. Methods: A literature review was conducted using PubMed, an international database. The target of the research was to collect at least 10 different surgical techniques. Results: Twelve different techniques were selected and cataloged. The flaps included were the bilobed flap, rhomboid flap, facial-artery-based flaps (nasolabial flap, island composite nasal flap, retroangular flap), cervicofacial flap, paramedian forehead flap, frontal hairline island flap, keystone flap, Karapandzic flap, Abbè flap, and Mustardè flap. Conclusions: The study of the facial subunits, the location and size of the defect, the choice of the appropriate flap, and respect for the vascular pedicles are the key elements for optimal outcomes. Full article

(1) Background: Nowadays, microvascular grafts are the gold standard in the reconstruction of midface defects after maxillectomy, however, not all patients may qualify for this type of surgery. The purpose of present study is to evaluate the benefits of alternative reconstruction methods such as full-thickness skin grafts for these conditions. (2) Methods: The research group consisted of 37 patients who underwent maxillectomy due to cancer of the mid-face and had full-thickness skin graft reconstruction. The study covered the period from 2011 to 2020. (3) Results: Based on the clinical examination and the subjective assessment of patients, a positive effect of the use of free skin grafts on their convalescence and rehabilitation was found. In particular, they contributed to the reduction in postoperative pain and pain associated with prosthetic stages (VAS Scale). (4) Conclusion: Full-thickness skin grafts in combination with individual prosthetic restorations are a good alternative to rehabilitation in patients who do not qualify for microsurgical treatment. Full article

Secondary corrective osteotomy of malunited craniofacial fractures can be a challenging proposition. The exposure, extrusion, and palpability of the titanium implants used become a genuine concern especially in areas of relatively thin skin, such as the periorbital region. Restoring a satisfactory contour to the midface is another major task for the plastic surgeon. Bone cement used to reconstruct craniofacial defects has existed for many years. However, most applications have been as a substitute for autogenous bone grafts for defects less than 25 cm². In this article, we present two cases of malunited facial fractures that underwent corrective osteotomy, during which we felt that despite the conventional osteotomy and reduction techniques, there was still either a small remnant step deformity or suboptimal contour smoothness due to prominence of the implants used. We thus used bone cement as a resurfacing medium over titanium implants to restore good malar contour and reduce the palpability and exposure rate of the titanium implants. We report good patient satisfaction with contour correction with no increase in wound infection rates or any delay in wound healing. There was initial chemosis associated with the use of the bone cement, which resolved in both patients within 3 to 4 weeks. Postoperative computed tomography showed some degree of osteointegration but no fraction of the bone cement. Calcium phosphate bone cement thus presents an attractive adjunctive method for midfacial contour resurfacing, when used in conjunction with conventional osteotomy procedures and as an onlay over prominent titanium implants. Full article