2012/11/01 by Eric Santamaría, Eric Santamaria, Susana Correa +6 · 31 citations
Biochemistry, Genetics and Molecular Biology · Dentistry · Medicine · #Cleft Lip and Palate Research #Debulking #Dentistry #Fibula #Free flap #Implant #Maxilla #Medicine #Osseointegration #Premaxilla #Reconstructive Facial Surgery Techniques #Reconstructive Surgery and Microvascular Techniques #Surgery #Tibia
paper · doi:10.1097/prs.0b013e31826864aa
published in Plastic & Reconstructive Surgery 130(5), 1023-1030 (Lippincott Williams & Wilkins)
openalex publication_date 2012/11/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
BACKGROUND: Reconstruction of the maxilla with the fibula free flap is a popular and well-described technique. The ideal intraoral lining would be mucosa, which is moist, thin, and non-hair-bearing. Prelamination of the fibula with buccal mucosa replaces like tissue with like tissue, obviates the need for a skin paddle, and facilitates placement of osseointegrated implants in a single stage. For central maxillary defects, the authors have shifted from using an osteocutaneous to a prelaminated free fibula flap. In this article, the authors report their experience using the prelaminated osteomucosal fibula for maxillary reconstruction. METHODS: From 2003 to 2011, 24 patients underwent reconstruction of a central maxillary defect using a free fibula flap. The first 10 patients had osteoseptocutaneous flaps, and the other 14 patients had prelaminated flaps. Data collected included patient age, cause of defect, type and number of operations, complications at both the donor and recipient sites, and placement of osseointegrated implants. RESULTS: The majority of patients in the series (n = 21) had central maxillary defects caused by loss of the premaxilla during early repair of bilateral cleft lip-cleft palate. There was one flap failure in the nonprelaminated flap group and one in the prelaminated group. Repeated debulking to thin the skin paddle was required in all of the patients with osteocutaneous flaps. CONCLUSIONS: Prelamination delivers like tissue to the recipient site, obviates the need for debulking, and may reduce donor-site wound problems. To the authors' knowledge, this is the largest series of prelaminated fibulas for maxillary reconstruction in the literature. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.