Abstract
It has been reported that in reconstructive surgery after excision of a maxillary tumor, a pedicled buccal fat pad graft is easier to perform than reconstructive surgery itself, closure of the access hole that arises in the oronasal cavity/paranasal sinus is achieved, and there are relatively few complications, such as dysarthria and eating disorders. The authors report here on a case they experienced, in which reconstruction of the lost portion of the palate after maxillary gingival cancer surgery was performed using a pedicled buccal fat pad graft, and the patient's QOL was improved. The patient was a 65-year-old male. Pain in the maxillary molar region gingiva, bone exposure, and surrounding tissue induration were observed, accompanied by crateriform hemorrhagic ulcers. In a biopsy, a pathological diagnosis of squamous cell cancer was reached. In the CT imaging findings, an osteoclastic image in the maxillary molar region was observed. However, according to the PET findings, metastasis to other regions was not observed. A TNM classification of T4N0M0 was decided upon. The treatment method was a single dose of chemotherapy using TS-1®, and clinically, a partial response (PR) result was obtained. Subsequently, under general anesthesia, partial excision of the maxilla bone and reconstruction of the lost portion with a buccal fat pad were performed. No post-operative complications were observed, no relapse or metastasis, etc. occurred, and the patient is doing well. Epithelialization of the transplanted region was seen within around 7 days, eating/swallowing/conversation were possible, and it was possible to return to society in a comparatively short time. This reconstructive surgery may be a useful method compared to jaw dentures and other reconstructive surgery.
