&NA; Prosthetic rehabilitation is essential for maintaining postoperative oral function after maxillary reconstruction. However, the maxillary prosthesis becomes unstable in some patients because of extensive palatomaxillary resection and drooping of the transferred flap. In such patients, maintaining sufficient oral function is difficult, especially if the patient is edentulous. To achieve prosthetic retention, the authors performed microvascular maxillary reconstruction with a slit‐shaped fenestration in the midline of the hard palate. Maxillary defects after subtotal or total maxillectomy were reconstructed with rectus abdominis musculocutaneous flaps in five patients. Defects of the nasal lining and palate were reconstructed with the single cutaneous portion of the flap, and a slitshaped fenestration was left between the cutaneous portion of the flap and the edge of the remaining hard palate. Postoperatively, patients were fitted with maxillary prostheses that had a flat projection for the palatal fenestration. In all patients, the prosthesis was stable enough for mastication and prevented nasal regurgitation. Speech function was rated as excellent on Hirose's scoring system for Japanese speech ability. The authors believe that their method of palatomaxillary reconstruction is both simple and reliable. (Plast. Reconstr. Surg. 111: 594, 2003.)
[1]
G. Funk,et al.
Functional dental rehabilitation of massive palatomaxillary defects: Cases requiring free tissue transfer and osseointegrated implants
,
1998,
Head & neck.
[2]
H. Matloub,et al.
Reconstruction After Infrastructure Maxillectomy Using Dual Free Flaps
,
1997,
The Laryngoscope.
[3]
T. McCulloch,et al.
Free-tissue transfer reconstruction of midfacial and cranio-orbito-facial defects.
,
1995,
Archives of otolaryngology--head & neck surgery.
[4]
N. B. Meland,et al.
Extensive defects of the sino-orbital region. Results with microvascular reconstruction.
,
1992,
Archives of otolaryngology--head & neck surgery.
[5]
K. Togawa,et al.
Primary Reconstruction after Total or Extended Total Maxillectomy for Maxillary Cancer
,
1981,
Plastic and reconstructive surgery.
[6]
J. Johnson,et al.
Immediate microvascular reconstruction of combined palatal and midfacial defects using soft tissue only
,
1988,
Microsurgery.