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KMID : 0903220090100010049
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Journal of the Korean Cleft Palate-Craniofacial Association
2009 Volume.10 No. 1 p.49 ~ p.54
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Inferior Orbital Wall Reconstruction with Vascularized Partial Thickness Calvarial Bone Flap in Three Cases of Maxillary Tumor
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Shin Sang-Ho
Lee Yoon-Jung
Kim Jun-Sik
Kim Nam-Gyun
Lee Kyung-Suk
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Abstract
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Purpose: Inevitably, Maxillary structural defect follows maxillary cancer extirpation. Maxillary reconstruction is over every surgeon’s head. Every physician tried to overcome limited donor site of craniofacial defect. We considered to suggest optimal method of inferior orbital wall defect in functional point as well as esthetic point.
Methods: We performed wide excision of maxilla and vascularized partial thickness calvarial bone flap to reconstruct the defect from cancer extirpation in three cases. We select ipsilateral superficial temporal artery, vein and outer cortex of parietal bone flap as donor. And we applied bone flap as inferior orbital wall structure. The bony surface was wrapped with fascia to prevent direct contact between orbital contents and rough bony flap surface. Computed tomography image was checked during follolw up period.
Results: We can observe these patients for over two years. In all three cases, We can get fair inferior orbital wall structure. Even though they got radiation therapy, there was no limitation of extraocular movements, no diplopia. no enophthalmos. Also there was minimal donor site morbidity.
Conclusion: We suggest vascularized calvarial bone flap is practically excellent strategy for inferior orbital wall reconstruction.
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KEYWORD
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Orbital wall reconstruction, Cranial bone graft, Calvarium, Superficial temporal artery
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