상악의 광범위한 결손에 대한 미세혈관 유리 피판 기반의 3차원 복합조직 재건

Abstract

Maxilla is a complex three-dimensional structure at midface. When wide defect occurred by oral cancer re section, it leaves a great challenge to oral and maxillofacial surgeons for the reconstruction of surgical defects. The wide maxilla defects usually include oral mucosa, skin, fascia and muscle as well as hard tissue such as dentition, bone structure. Consequently, great care should be given with the approach of composite 3D recon struction. A Microvascular free flap has been mainstay for maxilla reconstruction of multiple tissue defect. Fibula free flap, deep circumflex iliac artery free flap come as first choice. The composite 3D reconstruction is assisted by three dimensional image processing, 3D printing technology, polymer based fixation materials and concomitant soft tissue harvesting. The advanced treatment strategy for wide maxilla defect would be presented with three case reports in this article.