Complex Midfacial Reconstruction: A Combined Technique of Computer-Assisted Surgery and Microvascular Tissue Transfer

Abstract

The human midface is a complex anatomic region. The maxilla is the structural support between the skull base and the occlusal plane, resisting the forces of mastication, anchoring the dentition, separating the oral and nasal cavities, supporting the globe, and supporting the face and its mimetic musculature. 1 Futran N.D. Mendez E. Developments in reconstruction of midface and maxilla. Lancet Oncol. 2006; 7: 249 Abstract Full Text Full Text PDF PubMed Scopus (134) Google Scholar The midface region dominates our outward appearance, which is unique to each individual, and its esthetic restoration after loss of the maxilla is of major importance for quality of life. Destruction of the midface may result from trauma, infectious or malignant disease, as well as from rare disorders of the immune system. The morbidity associated with total maxillectomy potentially includes impairment of deglutition and nutrition, orbital function and vision, speech and communication, self-image and mental health, and maintenance of hygiene and social acceptability. 1 Futran N.D. Mendez E. Developments in reconstruction of midface and maxilla. Lancet Oncol. 2006; 7: 249 Abstract Full Text Full Text PDF PubMed Scopus (134) Google Scholar Reconstruction of midfacial defects still remains a surgical challenge, especially in cases with total loss of the maxilla including the orbital floor and preservation of orbital contents. 2 Cordeiro P.G. Santamaria E. Kraus D.H. et al. Reconstruction of total maxillectomy defects with preservation of the orbital contents. Plast Reconstr Surg. 1998; 102: 1874 Crossref PubMed Scopus (128) Google Scholar The overall goal is to replace the form and function of native tissue. In addition to separation of oral and nasal cavities, the contours of the bony orbit and the zygomatic prominence should be exactly restored, preserving optical function and facial symmetry. The prevention of diplopia as a result of postoperative enophthalmos should be of major importance, especially when orbital contents are not affected. ErratumJournal of Oral and Maxillofacial SurgeryVol. 72Issue 4PreviewIn “Complex Midfacial Reconstruction: A Combined Technique of Computer-Assisted Surgery and Microvascular Tissue Transfer” (Kokemueller et al., J Oral Maxillofac Surg 66:2398-2406) the author Martin Rücker MD, DMD, PhD should be listed as “Martin Rücker, MD, DMD”. Full-Text PDF