Maxillary reconstruction: Current concepts and controversies
Identifieur interne : 000F27 ( Ncbi/Checkpoint ); précédent : 000F26; suivant : 000F28Maxillary reconstruction: Current concepts and controversies
Auteurs : Subramania Iyer [Inde] ; Krishnakumar Thankappan [Inde]Source :
- Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India [ 0970-0358 ] ; 2014.
Abstract
Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.
Url:
DOI: 10.4103/0970-0358.129618
PubMed: 24987199
PubMed Central: 4075223
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Maxillary reconstruction: Current concepts and controversies</title><author><name sortKey="Iyer, Subramania" sort="Iyer, Subramania" uniqKey="Iyer S" first="Subramania" last="Iyer">Subramania Iyer</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala</wicri:regionArea><wicri:noRegion>Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Thankappan, Krishnakumar" sort="Thankappan, Krishnakumar" uniqKey="Thankappan K" first="Krishnakumar" last="Thankappan">Krishnakumar Thankappan</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala</wicri:regionArea><wicri:noRegion>Kerala</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24987199</idno><idno type="pmc">4075223</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075223</idno><idno type="RBID">PMC:4075223</idno><idno type="doi">10.4103/0970-0358.129618</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000254</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000254</idno><idno type="wicri:Area/Pmc/Curation">000254</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000254</idno><idno type="wicri:Area/Pmc/Checkpoint">000228</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000228</idno><idno type="wicri:Area/Ncbi/Merge">000F27</idno><idno type="wicri:Area/Ncbi/Curation">000F27</idno><idno type="wicri:Area/Ncbi/Checkpoint">000F27</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Maxillary reconstruction: Current concepts and controversies</title><author><name sortKey="Iyer, Subramania" sort="Iyer, Subramania" uniqKey="Iyer S" first="Subramania" last="Iyer">Subramania Iyer</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala</wicri:regionArea><wicri:noRegion>Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Thankappan, Krishnakumar" sort="Thankappan, Krishnakumar" uniqKey="Thankappan K" first="Krishnakumar" last="Thankappan">Krishnakumar Thankappan</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala</wicri:regionArea><wicri:noRegion>Kerala</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India</title><idno type="ISSN">0970-0358</idno><idno type="eISSN">1998-376X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. 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S" uniqKey="Ferrari S">S Ferrari</name></author><author><name sortKey="Copelli, C" uniqKey="Copelli C">C Copelli</name></author><author><name sortKey="Boni, P" uniqKey="Boni P">P Boni</name></author><author><name sortKey="Sesenna, E" uniqKey="Sesenna E">E Sesenna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Niu, Xg" uniqKey="Niu X">XG Niu</name></author><author><name sortKey="Zhao, Ym" uniqKey="Zhao Y">YM Zhao</name></author><author><name sortKey="Han, Xx" uniqKey="Han X">XX Han</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sandor, Gk" uniqKey="Sandor G">GK Sándor</name></author><author><name sortKey="Tuovinen, Vj" uniqKey="Tuovinen V">VJ Tuovinen</name></author><author><name sortKey="Wolff, J" uniqKey="Wolff J">J Wolff</name></author><author><name sortKey="Patrikoski, M" uniqKey="Patrikoski M">M Patrikoski</name></author><author><name sortKey="Jokinen, J" uniqKey="Jokinen J">J Jokinen</name></author><author><name sortKey="Nieminen, E" uniqKey="Nieminen E">E Nieminen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mesim Ki, K" uniqKey="Mesim Ki K">K Mesimäki</name></author><author><name sortKey="Lindroos, B" uniqKey="Lindroos B">B Lindroos</name></author><author><name sortKey="Tornwall, J" uniqKey="Tornwall J">J Törnwall</name></author><author><name sortKey="Mauno, J" uniqKey="Mauno J">J Mauno</name></author><author><name sortKey="Lindqvist, C" uniqKey="Lindqvist C">C Lindqvist</name></author><author><name sortKey="Kontio, R" uniqKey="Kontio R">R Kontio</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Iyer, Subramania" sort="Iyer, Subramania" uniqKey="Iyer S" first="Subramania" last="Iyer">Subramania Iyer</name></noRegion><name sortKey="Thankappan, Krishnakumar" sort="Thankappan, Krishnakumar" 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