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Surgical Mini-Lectures and Clinics

Thursday, September 15, 2011
3:30PM - 5:30PM

Location

(C) 104A-B

S236

Free Tissue Transfer: A Defect Oriented Approach to Maxillomandibular Reconstruction

Daniel Buchbinder, DMD, MD
Professor and Chief, Otolaryngology, Head and Neck Surgery
Beth Israel Medical Center
New York, NY

Mark Urken, MD, FACS
Professor and Chief, Head and Neck Oncology, Otolaryngology / Head and Neck Surgery
Beth Israel Medical Center
New York, NY

Synopsis

This presentation will go over the systematic approach to oro-mandibular and palato-maxillary reconstruction that our multidisciplinary team has developed over the past 23 years. A defect oriented Classification scheme that allows for the selection of a specific reconstructive technique and the timing of fixture placement will be discussed. The rationale and evidence for primary fixture placement will be made. The use of alloplasts, free bone grafts and Vascularized flaps will be presented. The use of bone containing vascularized flaps has become the main stay of this type of reconstructive procedure because the predictable blood supply of the reconstructed structures affords additional safety when delivering adjunctive radiotherapy in the post operative period. Furthermore the ability to transfer bone of sufficient stock to provide an adequate platform for the placement of endosteal fixtures to help anchor tissue or implant borne prostheses has allowed the reconstructive team to functionally restore these patients. Reconstructive success can no longer be measured by the satisfactory restoration of form but rather by the patient’s ability to function.

Learning Objectives

At the conclusion of this presentation, participants should be able to:

  1. Describe a defect oriented approach to Oromandibular reconstruction
  2. Describe the various options available for the reconstructive surgeon to achieve a functional reconstruction of post ablative oromandibular defects
  3. Describe the use and timing for the placement of endosteal titanium fixtures in oromandibular recionstruction

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