Reconstructive Oral and Maxillofacial Surgery

Reconstructive Oral and Maxillofacial Surgery

Carlos Navarro Vila Editor Reconstructive Oral and Maxillofacial Surgery

Editor Carlos Navarro Vila Hospital General Universitario Gregorio Marañón Madrid Spain ISBN 978-3-319-20486-4 DOI 10.1007/978-3-319-20487-1 ISBN 978-3-319-20487-1 (ebook) Library of Congress Control Number: 2015947347 Springer Cham Heidelberg New York Dordrecht London Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)

Preface Reconstruction of head and neck defects after tumor resection is one of the main challenges facing the maxillofacial surgeon. Such complex defects require not only cosmetic reconstruction but also functional reconstruction that enables patients to return to their family, social, and professional life under optimal conditions and as quickly as possible. While resection surgery has developed little in recent years with the exception of new techniques, such as navigation, that enable safer and more adapted procedures reconstruction has advanced considerably, with the incorporation of free flaps and virtual planning, which makes it possible to model flaps and customize prostheses to the defect. These advances are evident in reconstruction of the mandible. Various pedicle flaps have been used to provide bone. The outcome has generally been unsatisfactory, except for Demergasso s trapezius osteomyocutaneous flap, which proved to be a very acceptable option for cosmetic and functional reconstruction. The advent of free fibula flaps and scapula flaps revolutionized reconstruction and enabled defects to be repaired with high-quality bone and abundant soft tissue. The placement of dental implants in transferred bone makes it possible to insert prostheses that restore chewing and phonation and considerably improve labial competence. Software-based virtual surgery enables more accurate anatomical reconstruction using customized plates and cutting guides for the flap bone, which can be adapted exactly to the defect left by resection and to the patient s original facial structure. Similarly, pedicle flaps and microsurgical flaps have transformed the reconstruction of defects of the maxilla and the middle third. Each chapter of this book covers a specific area on the spectrum of head and neck reconstruction: mandibular reconstruction, reconstruction of the middle third, reconstruction of the cranio-orbital region, reconstruction of soft tissue defects, treatment of facial paralysis, dental implants, and regional flaps, which continue to be extremely useful. We present our experience in the Maxillofacial Surgery Department of Hospital General Universitario Gregorio Marañón, Madrid, Spain, where these techniques have been taught to numerous specialists from Spain, Europe, and South America. Madrid, Spain Carlos Navarro Vila v

Contents 1 Mandibular Reconstruction.................................... 1 Carlos Navarro Cuellar, Cristina Maza Muela, Santiago José Ochandiano Caicoya, and Carlos Navarro Vila 2 Maxillary and Middle Face Reconstruction...................... 39 Carlos Navarro Vila, Ana María López López, Cristina Maza Muela, and Carlos Navarro Cuellar 3 Reconstruction of the Cranio-Orbital Region.................... 77 Julio Acero Sanz, Cristina Maza Muela, José Ignacio Salmerón Escobar, and Santiago José Ochanciano Caicoya 4 Reconstruction of Soft Tissue Defects Using Microsurgical Flaps........................................ 103 Ignacio Navarro Cuellar, Teresa González Otero, José Alfonso Ruiz Cruz, and Carlos Navarro Vila 5 Reconstruction of Soft Tissue Defects with Regional Flaps........ 129 José Ignacio Salmerón Escobar, José Alfonso Ruiz Cruz, Ana María López López, and Carlos Navarro Vila 6 Functional Implant-Supported Dental Rehabilitation in Oncologic Patients....................................... 163 Santiago Jose Ochandiano Caicoya, Carlos Navarro Cuellar, Julio Acero Sanz, and Carlos Navarro Vila 7 Reconstruction in Facial Paralysis............................ 203 Teresa González Otero and Ignacio Navarro Cuellar Index......................................................... 221 vii

Contributors Julio Acero Sanz, MD, DDS, PhD, FEBOMS Head of Oral and Maxillofacial Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain Associate Professor of Alcalá University, Madrid, Spain Teresa González Otero, MD, PhD, FEBOMS Consultant at Oral and Maxillofacial Surgery Department, La Paz University Hospital, Madrid, Spain Ana María López López, MD, DDS, FEBOMS Consultant at Oral and Maxillofacial Surgery Department, Miguel Servet University Hospital, Zaragoza, Spain Cristina Maza Muela, MD, DDS, FEBOMS Consultant at Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain Carlos Navarro Cuellar, MD, DDS, PhD, FEBOMS Associate Professor Medical Faculty, Complutense University of Madrid, Madrid, Spain Consultant at Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain Ignacio Navarro Cuellar, MD, DDS, FEBOMS Consultant at Oral and Maxillofacial Surgery Department, Virgen de la Salud Hospital, Toledo, Spain Carlos Navarro Vila, MD, DMD, PhD, FEBOMS Full Professor Medical Faculty, Complutense University of Madrid, Madrid, Spain Head of Oral and Maxillofacial Department Surgery, Gregorio Marañón General University Hospital, Madrid, Spain Académico Correspondiente of the Royal National Academy of Medicine of Spain, Madrid, Spain Santiago José Ochandiano Caicoya, MD, DDS, FEBOMS Consultant at Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain ix

x Contributors José Alfonso Ruiz Cruz, MD, DDS, FEBOMS Consultant at Oral and Maxillofacial Surgery Department, University Hospital del Sur, Madrid, Spain José Ignacio Salmerón Escobar, MD, PhD, FEBOMS Associate Professor Medical Faculty, Complutense University, Madrid, Spain Consultant at Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain