Abstract
The maxillary region consists of the nasal and oral cavity, and is an important constituent of facial appearance. Careful consideration is essential for a functional and aesthetic reconstruction.
Our strategy for maxillary reconstruction is as follows, 1) the skin paddle of the rectus abdominis musclocutaneous flap is designed to fulfill the reconstructive issues concerning the orbit, the palate and nasal lining, 2) in the skeletal reconstruction, the methods depend on whether the subcutaneous fat is thick or thin; the former is reconstructed by the rectus abdominis myocutaneous flap combined with vascularized costal cartilages, the latter by artificial bone, and 3) reconstruction the eyelids and eye socket of is carried out in a secondary operation when atrophy of transferred tissue after 1 year has ceased.
As a functional device, we performed the reconstruction of a nasal lining by the mucosal hinged flap which can be elevated in the secondary operation. This method diminished the unpleasant complication caused by the skin paddle.
For aesthetic reasons, dynamic reconstruction is positively performed after reconstruction of the eyelids and eye socket. Natural wrinkles appear in the lateral canthal region by this method, and a nice smile can be obtained.
