Objective: To reconstruct the maxillary defect by using free vascularized iliac osteo-musculo-cutaneous flap combined with immediate zygomatic implantation for early rehabilitation of maxillary contour and masticatory function.
Methods: In August 2003, the patient presented with deformity of left middle face (Brown II type defect) after subtotal maxillectomy. After hospitalization, a set of preoperative preparations were made, including spiral CT scanning, manufacture of nature size anatomical model and implantation protocol design. The maxillary defect was reconstructed with free vascularized iliac osteo-musculo-cutaneous flap combined with simultaneous insertion of one Bränemark zygomatic implant and two general implants. Six months later the prosthesis were placed.
Results: The vascularized osteo-musculo-cutaneous flap survived, the osseointegration was observed between bone and implant 6 months later. The contour of face and palate was satisfactory, the normal occluding relation was gained. The average masticatory force of operative side was 76.3% of the normal side. No tumor recurrence was noticed during the follow-up of 14 months.
Conclusion: It is a reliable method for functional reconstruction of maxillary defect via vascularized iliac osteo-musculo-cutaneous flap combined with immediate zygomatic implantation.