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Midface reconstruction is challenging because the structures and deformities involved are complicated. In this study, we present a strategy for integrally reconstructing nasal and midface defects, including hair-bearing defects, using extended forehead-expanded flaps. From 2015 to 2018, a total of 22 patients with midface defects underwent reconstruction with extended forehead-expanded flaps. The far end of the expanded flap, which included scalp hair, was used to cover the upper lip defect (Type 1). In cases with large perioral defects (Type 2), we designed two separate supratrochlear artery flaps, one with a shorter pedicle for nasal reconstruction and the other with a longer pedicle for partial reconstruction. The pedicle of the longer flap was saved for upper lip recovery after pedicle interruption. Among the 22 patients (13 male and 9 female), 17 were caused by burns and 5 by trauma. Nineteen patients had Type 1 defects, and three had Type 2 defects. The average postoperative follow-up was 17.6 ± 4.3 months. Patient satisfaction was excellent in most patients. Our extended forehead flap strategy can achieve aesthetic recovery of nasal and perioral defects with a single expansion treatment. The expanded flap can be flexibly designed to fit diverse midface defects.
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http://dx.doi.org/10.1089/fpsam.2020.0484 | DOI Listing |
Head Neck
September 2025
Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Objective: Reconstruction of complex midface defects is challenging. Vascularized composite flaps are often needed to replace missing premaxilla and palatal bone, oral and sinonasal lining, as well as external facial skin in these defects. The submental flap has the potential to provide all these various tissues with the added advantage of matching facial skin color and hair-bearing qualities and is available within the surgical field.
View Article and Find Full Text PDFArch Craniofac Surg
August 2025
Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
Background: The most complex and debated aspect of head and neck reconstructive surgery is the management of midface defects caused by malignant or non-malignant diseases. This study proposes a new classification system for patients with midface defects arising from non-malignant and non-traumatic diseases.
Methods: In this study, 107 patients with midface defects resulting from mucormycosis were evaluated according to the anatomical locations of involvement and the differences between the affected areas.
Bioinformation
May 2025
Department of Oral & Maxillofacial Surgery, Inderprastha Dental College and Hospital, Sahibabad, Ghaziabad, Uttar Pradesh, India.
The importance of full thickness skin graft for reconstruction or Rehabilitation after Maxillectomy and mid face defect is well known. In this study we included 50 patients who underwent maxillectomy due to cancer of the mid-face and had full-thickness skin graft reconstruction. Based on the clinical examination and the subjective assessment of patients, a positive effect of the use of free skin grafts on their convalescence and rehabilitation was found.
View Article and Find Full Text PDFJ Craniomaxillofac Surg
August 2025
State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China. Electronic address:
For morphological assessments and treatment planning for the midface, the conventionally used measurement-based diagnosis is not potent enough to decode the complexity of craniofacial configuration. A more comprehensive assessment system using a machine learning-assisted approach is in need. In this study, the subnasale and maxilla positions were assessed in relation to the upper- and mid-facial structures in 1293 Asian females.
View Article and Find Full Text PDFTransl Pediatr
July 2025
Department of Gynecology and Obstetrics, Mario Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba, MG, Brazil.
Background: Craniosynostosis, the premature fusion of cranial sutures, may occur in isolated or syndromic forms. Among syndromic craniosynostoses, Apert syndrome is a rare but significant condition, characterized by a triad of multisuture craniosynostosis, midface hypoplasia, and symmetric syndactyly of the hands and feet. Early prenatal diagnosis is challenging but essential for appropriate counseling and perinatal planning.
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