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Introduction. The objective of this study was to evaluate a surgical technique and to present the results of delayed reconstruction of palatomaxillary defects using fibula free flap (FFF). Methods. A review was conducted for nine patients who underwent palatomaxillary reconstruction using FFF. Primary disease, type of reconstruction, defect area, fibula segment length and number of osteotomies, radiotherapy, and implant installation after FFF reconstruction were analyzed. Results. All nine patients underwent delayed reconstruction. The fibula shaft was osteotomized into two segments in seven patients and three segments in one patient with bilateral Brown’s revised classification IV/d defect. One case was planned by using a computer-aided design computer-aided manufacturing (CAD/CAM) system with a navigation system. The mean length of the grafted fibula bone was 68.06 mm. Dental implant treatment was performed in six patients. Six patients received radiation therapy, and there were no specific complications related to the radiation therapy. In one case, the defect was reconstructed with FFF flow-through from a radial forearm free flap. Conclusion. This clinical study demonstrated that the fibula flap is an ideal donor-free flap in a palatomaxillary defect. Delayed reconstruction using an FFF can reduce the complication and failure rates. Full article

Objective: Maxillectomy often results in a high level of morbidity with significant psychological and functional implications for patients. The aims of the present study were to assess the effectiveness of the maxillary obturator as a speech rehabilitation aid, to examine the influence of dentition on speech intelligibility, to restore patients’ regular daily activity as soon as possible, and to maintain patients’ psychological well-being throughout the treatment. Patients and Methods: Forty-one palatomaxillary immediate obturator and definitive reconstruction patient treatments were reviewed at a clinic (Ankara, Turkey). Patients aged between 20 and 73 years with surgically acquired partial maxillary defects were included in this study. All patients were rehabilitated with immediate and definitive obturators. The patients were given immediate surgical obturators which were adjusted to the defect area with a tissue conditioner. By employing this procedure and relining with the tissue conditioner weekly, immediate obturators were used in the interim stage of the treatment. As interim obturators, prostheses were used for two to three months until healing and resorption were found satisfactory, after which the definitive obturators were fabricated. Results: The speech intelligibility test (SIT) was employed for the evaluation of the speech ability. Significant improvements were found in the mean speech intelligibility test score (SITS), from 0.02% in patients without prosthetic obturation to 94.10% in patients with immediate obturation on the second day, 95.60% in patients with immediate obturation on the 20th day, and 95.97% in patients with definitive obturation. Full article