RECONSTRUCTION FOR PALATAL DEFECTS OF MAXILLARY CANCER ABLATIVE SURGERY USING A SOFT-TISSUE FREE FLAP WITH A TITANIUM MESH PLATE OR A FIBULA OSTEOCUTANEOUS FREE FLAP

NAKAYAMA Bin, TORRI Shuhei, KAMEI Yuzuru, TORIYAMA Kazuhiro, HYODO Ikuo, HASEGAWA Yasuhisa, FUJIMOTO Yasushi, MATSUURA Hidehiro, TOHNAI Iwai, OKAZAKI Yasuhiro, SHIGETOMI Toshio, NAKAI Hidetaka, UEDA Minoru, HACHIYA Yuji

doi:10.5981/jjhnc1974.27.685

When a palatal defect after maxillary cancer ablative surgery is closed by a soft tissue free flap only, we assume that it will be difficult to wear a denture, because gravity causes the palatal flap to sag. On the other hand, we recognize that a reconstructed palate prevents liquid from flowing into the nasal cavity and also relieves the mental stress that comes with using a huge dental prosthesis.<br>In ten patients who underwent maxillary cancer ablative surgery, a conventional soft tissue free flap with a three-dimensional titanium mesh plate, was transferred to close the palatal defect and prevent the transferred free flap from sagging. In another eight patients, an alveolar bone reconstruction and palatal defect closure was performed using a fibula osteocutaneous free flap with or without osseointegrated implants. With the former method, four of ten cases (40%) were able to wear a dental prosthesis, and with the latter method, four of eight cases (50%) were able to. These results were better than those of a soft tissue free flap transfer only (16.7%).<br>The soft tissue free flap with a three-dimensional titanium mesh plate is thought to be a useful procedure for enabling patients to wear a denture. The fibula osteocutaneous flap is also thought to be a useful alternative as a procedure that results in excellent masticatory function.

RECONSTRUCTION FOR PALATAL DEFECTS OF MAXILLARY CANCER ABLATIVE SURGERY USING A SOFT-TISSUE FREE FLAP WITH A TITANIUM MESH PLATE OR A FIBULA OSTEOCUTANEOUS FREE FLAP

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