J Korean Assoc Oral Maxillofac Surg 2009; 35(1): 13~20
PRELAMINATED FREE FLAP FOR THE RECONSTRUCTION OF MAXILLARY DEFECTS
Ji-Youn Kim, Kang-Mi Pang, Jong-Chul Park, Sung-Min Kim, Hoon Myoung, Myung-Jin Kim, Jong-Ho Lee
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background In contrast to defects of the mandible and mouth floor region, in the defect of maxilla, the availability of firmly attached oral and nasal
mucosal linings is needed. In addition to it, in consider of operation field, operating convenience, and esthetics, reconstruction using prelaminated flap
is strongly recommended. Therefore we consider the prelaminated flap through the cases that is reconstructed using prelaminated forearm flap and
prelaminated scapular flap. Patients and Methods From 2001 to 2008, in OMFS SNUDH, there were 6 cases that had reconstruction using prelaminated
forearm free flap and other 3 cases that had reconstruction using prelaminated scapular flap of maxilla. The average age of patients that were
reconstructed using prelaminated forearm free flap was 47.5 years, the average prelaminated period (after 1st operation ~ until 2nd operation) was 51.8
days and the average follow-up period after 2nd operation was 35.3 months. As well, the average age of patients that were reconstructed using prelaminated
scapular free flap was 37 years, the average prelaminated period (after 1st operation ~ until 2nd operation) was 57 days and the average follow-up
period after 2nd operation was 42.3 months. Results Except 1 case that were reconstructed using prelaminated scapular flap, we could get firmly
attached oral and nasal stable skin(mucosal like) lining, more adequate thickness flap than any other flap and improved esthetic and functional results
in the other 8 cases that were reconstructed using prelaminated flap. The complications of the prelaminated forearm flap cases were inconvenient
swallowing, sputum, limitation of mouth opening and difficult mastication. It came from flap shrinkage of the flap in some aspect, as well as other
combined operations such as mass resection or RND. The difficult point of the reconstruction of prelaminated scapular flap was the possibility of vascular
damage at preparation of flap in 2nd surgery. The damage could cause the failure of the prelaminated scapular flap. And the skin-lining of the
prelaminated flap had limitations, so it is needed to study about the cultured oral epithelium-lining flap instead of the skin-lining flap. Conclusion We
considered about advantages, complications and notable things of prelaminated flap through maxillary reconstruction cases using prelaminated forearm
flap and prelaminated scapular flap so far. Furthermore, we should go on studying for functional reconstruction of prelaminated fasciomucosal
flap using cultured oral epithelium.
Keywords: Prelaminated forearm flap, Prelaminated scapular flap, Maxillofacial reconstruction, Maxillary defect


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