Case of the maxillofacial defect patient. Prosthetic treatment after reconstruction of the palate and face using deltopectral flap

Abstract

The patient, a 72-year-old edentulous man, had an extensive maxillofacial defect caused by treatment of the maxillary cartinoma. As his left maxillary and zygomatic bone, a portion of the soft palate, orbital cavity contents and soft tissues of the cheek had been excised, his face was ugly, and his speech and eating were extremely poor. For this patient, first of all, plastic surgeons reconstructed the cheek and palate using deltopectral flap. Secondly, dentists prepared a facial prosthesis and a set of complete dentures. Four months after prosthetic treatment, plastic surgeons corrected the left corner of the mouth using temporal muscle flap and fascia lata, and strengthened infraorbial region of deltopectral flap by grafting the left 5th rib. Lastly, dentists remade the facial prosthesis. As a result, the patient had great improvement in his face, speech and eating. Periodic examination of the surgical site can be practiced through the remaining facial defect. The advantages of the surgical reconstruction in this case were as follows. (1) As reconstruction of the cheek narrowed a facial defect, it was easy to improve patient's appearance by a small facial prosthesis. (2) The closure of the palate was effective to improve hypernasal speech, to prevent fluid leakage into the nasal cavity and to improve the retention and stability of the upper complete denture.