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http://dx.doi.org/10.21593/kjhno/2022.38.1.53

Simultaneous Reconstruction of a Subtotal Maxillectomy and Columella Deficit using Radial Forearm and Preauricular Free Flaps  

Yoon, Taekeun (Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Eun, Seokchan (Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Cho, Sung-Woo (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Rhee, Chae-Seo (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Publication Information
Korean Journal of Head & Neck Oncology / v.38, no.1, 2022 , pp. 53-57 More about this Journal
Abstract
Reconstruction of subtotal maxillectomy defects with columella deficit is challenging. We report a unique case of facial reconstruction using a free radial forearm flap and a free preauricular flap for the maxillectomy and columella deficit. A 73-year-old woman was diagnosed with recurrent sebaceous carcinoma of the nose. We performed wide excision, including areas of the right cheek, nose, upper lip, maxilla, and columella. The resultant subtotal maxillectomy defect was reconstructed using a three-dimensional flap. First, a free radial forearm flap was transfered to resurface the nasal, oral, and external facial side. Second, a preauricular flap was positioned into the columella defect and anastomosed with the distal portion of the radial forearm flap pedicle. The two flaps survived, and the patient recovered uneventfully. We believe the radial forearm and preauricular double free flaps with the pedicle connection method were effective in reconstructing the present case of subtotal maxillectomy defect.
Keywords
Free tissue flaps; Maxilla; Microsurgery; Nose; Reconstructive surgical procedures;
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1 Cordeiro PG, Santamaria E. A classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg. 2000;105:2331-2347.   DOI
2 Disa JJ, Liew S, Cordeiro PG. Soft-tissue reconstruction of the face using the folded/multiple skin island radial forearm free flap. Ann Plast Surg. 2001;47:612-619.   DOI
3 Schusterman MA, Reece GP, Miller MJ, Harris S. The osteocutaneous free fibula flap: Is the skin paddle reliable? Plast Reconstr Surg. 1992;90:787-793.   DOI
4 Iacoviello P, Bacigaluppi S, Gramegna M, Callegari S, Signorini G, Verrina G. Microsurgical three-dimensional reconstruction of complex nasal and midfacial defect: Multistep procedure respecting aesthetic unit criteria. J Craniofac Surg. 2021;32:1517-1520.   DOI
5 Burm JS, Yang WY. Modification of running Y-V plasty to correct bilateral nostril stenosis with a circular, linear contracture. J Plast Reconstr Aesthet Surg. 2011;64:1665-1668.   DOI
6 Santamaria E, Cordeiro PG. Reconstruction of maxillectomy and midfacial defects with free tissue transfer. J Surg Oncol. 2006;94:522-531.   DOI
7 Andrades P, Militsakh O, Hanasono MM, Rieger J, Rosenthal EL. Current strategies in reconstruction of maxillectomy defects. Arch Otolaryngol Head Neck Surg. 2011;137:806-812.   DOI
8 Brown JS, Rogers SN, McNally DN, Boyle M. A modified classification for the maxillectomy defect. HEAD NECK-J SCI SPEC. 2000;22:17-26.   DOI
9 Chen SH, Kuo YL, Chang TY, Lee YC. Use of anterolateral thigh flap and fibula flap in oncologic maxillary reconstruction: An algorithm approach. Ann Plast Surg. 2020;84:S17-25.   DOI
10 Sarukawa S, Kamochi H, Noguchi T, Sunaga A, Uda H, Mori Y, et al. Free-flap surgical correction of facial deformity after anteromedial maxillectomy. J Craniomaxillofac Surg. 2017;45:1573-1577.   DOI
11 Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: Introducing a new classification. Lancet Oncol. 2010;11:1001-1008.   DOI
12 Mehta S, Sarkar S, Kavarana N, Bhathena H, Mehta A. Complications of the pectoralis major myocutaneous flap in the oral cavity: A prospective evaluation of 220 cases. Plast Reconstr Surg. 1996;98:31-37.   DOI
13 Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg. 1985;76:239-247.   DOI
14 Liu F, Xu H, Wang T, Dong J, Dai C. Columella lengthening by a vascularized preauricular flap. Aesthetic Plast Surg. 2013;37:232-239.   DOI
15 Yen CI, Chang CS, Chen HC, Yang SY, Chang SY, Yang JY, et al. Paranasal augmentation with composite graft transfer in over-resection of alar base and nostril contracture. Ann Plast Surg. 2021;86:133-136.   DOI