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S232: Local Flaps in Facial Reconstruction
Surgical Clinics surgical design, and the outcomes will be discussed in detail.
Urken ML, Cheney ML, Sullivan MJ, et al: Atlas of Regional and Free Flaps for Head and Neck Recostruction. New York, NY, Raven Press, 1995.
References Guerrero C, Bell WH, Contasti GI, et al: Mandibular widening by intraoral distraction osteogenesis. Br J Oral Maxillofac Surg 35:383, 1997 Liou EJ, Huang CS: Rapid canine retraction through distraction of the periodontal ligament. Am J Orthod Dentofac Orthop 114:372, 1998 Kisnisci RS, Iseri H, Tuz H, et al: Dentoalveolar Distraction Osteogenesis for Rapid Orthodontic Tooth Movement J Oral Maxillofac Surg 60:389, 2002
S232 Local Flaps in Facial Reconstruction Joseph I. Helman, DMD, Ann Arbor, MI Brent B. Ward, DDS, MD, Ann Arbor, MI The oral and maxillofacial surgeon has been, traditionally, the leading professional in the area of treatment of facial trauma, especially in reconstruction of the facial skeleton and the rehabilitation of the resulting functional disabilities. However, the aspect of soft tissue reconstruction by the use of pedicled local and regional flaps has been relatively neglected in the overall scope of our specialty. Considering the experience and understanding by the oral and maxillofacial surgeons of the functional characteristics of the different tissues in the facial area, a comprehensive approach to soft tissue reconstruction was considered by the presenters as a needed addition to the operative armamentarium of our colleagues. Until the late 1960s, most of the flaps were tubed or delayed, and since the early 1970s there has been a significant development of pedicled vascularized tissues, either advanced, rotated, or transpositioned into a deficient recipient site. The literature is rich in this field, with numerous flaps published as technical notes, case reports, and anecdotal comments. The scientific support by research in the areas of vascularization and tissue healing expanded the knowledge and therefore increased the predictability of the use of flaps. The objective of the presentation is to address the concepts of the design of local flaps with a “problemsolving” approach based on the anatomic and physiologic basis of each flap, the clinical data accumulated through the literature, and the clinical experience of the presenters. The indications for the use of different flaps as well as the short- and long-term results will be discussed. References Baker SR, Swanson NA: Local Flaps in Facial Reconstruction. St. Louis, MO, Mosby, 1995 Jackson IT: Local Flaps in Head and Neck Reconstruction. St. Louis, MO, Mosby, 1985
AAOMS • 2008
S233 Contemporary Rhinoplasty for the Oral and Maxillofacial Surgeon Faisal A. Quereshy, DDS, MD, Cleveland, OH Rhinoplasty procedures have been primarily developed and studied by other surgical colleagues. Traditional techniques for cosmetic nasal surgery have included open and closed approaches to the intra-nasal structures. Only within the last two decades have more oral and maxillofacial surgeons incorporated aesthetic nasal surgery into their practices. The objectives of this course will review internal and external nasal anatomic relationships, preoperative patient selection with an emphasis on data collection and treatment planning; discussion of the various surgical approaches including the surgical sequence, precise surgical techniques; and finally the post-surgical care and evaluation including the prompt recognition and management of potential complications. Upon completion, the skilled surgeon can quickly integrate the rhinoplasty – nasal reshaping procedure – as a stand alone procedure in their facial cosmetic surgery practice. References Kennedy BK: Fonseca Oral & Maxillofacial Surgery Vol. 6. “Cosmetic Rhinoplasty” Philadelphia, WB Saunders, 2000, p. 203 Waite PD: Atlas of Oral and Maxillofacial Surgery Clinics of NA. Rhinoplasty 3:2 Philadelphia, WB Saunders, 1985 Epker BN: Esthetic Maxillofacial Surgery “Septorhinoplasty”. Malvern, Lea & Febiger, 1994, p 167-242
S234 Principles for the Revision of Total Alloplastic TMJ Prostheses Louis G. Mercuri, DDS, MS, Maywood, IL It has been almost four decades since Sir John Charnley reported successful total alloplastic joint reconstruction in the orthopaedic surgery literature. The evolution of surgical techniques, implant materials and implant designs have all led to excellent long-term results in older, less active individuals. Survival rates exceeding 90% after 10 years are reported. Encouraged by these results, orthopaedists have widened the indications for total joint replacement increasing the number being implanted in young and middle-aged active patients. Just as the modern practice of reconstructive orthopaedic joint surgery would be unthinkable, so should it be with reconstructive oral and maxillofacial surgery when it comes to the temporomandibular joint. 155
Urken ML, Cheney ML, Sullivan MJ, et al: Atlas of Regional and Free Flaps for Head and Neck Recostruction. New York, NY, Raven Press, 1995.
References Guerrero C, Bell WH, Contasti GI, et al: Mandibular widening by intraoral distraction osteogenesis. Br J Oral Maxillofac Surg 35:383, 1997 Liou EJ, Huang CS: Rapid canine retraction through distraction of the periodontal ligament. Am J Orthod Dentofac Orthop 114:372, 1998 Kisnisci RS, Iseri H, Tuz H, et al: Dentoalveolar Distraction Osteogenesis for Rapid Orthodontic Tooth Movement J Oral Maxillofac Surg 60:389, 2002
S232 Local Flaps in Facial Reconstruction Joseph I. Helman, DMD, Ann Arbor, MI Brent B. Ward, DDS, MD, Ann Arbor, MI The oral and maxillofacial surgeon has been, traditionally, the leading professional in the area of treatment of facial trauma, especially in reconstruction of the facial skeleton and the rehabilitation of the resulting functional disabilities. However, the aspect of soft tissue reconstruction by the use of pedicled local and regional flaps has been relatively neglected in the overall scope of our specialty. Considering the experience and understanding by the oral and maxillofacial surgeons of the functional characteristics of the different tissues in the facial area, a comprehensive approach to soft tissue reconstruction was considered by the presenters as a needed addition to the operative armamentarium of our colleagues. Until the late 1960s, most of the flaps were tubed or delayed, and since the early 1970s there has been a significant development of pedicled vascularized tissues, either advanced, rotated, or transpositioned into a deficient recipient site. The literature is rich in this field, with numerous flaps published as technical notes, case reports, and anecdotal comments. The scientific support by research in the areas of vascularization and tissue healing expanded the knowledge and therefore increased the predictability of the use of flaps. The objective of the presentation is to address the concepts of the design of local flaps with a “problemsolving” approach based on the anatomic and physiologic basis of each flap, the clinical data accumulated through the literature, and the clinical experience of the presenters. The indications for the use of different flaps as well as the short- and long-term results will be discussed. References Baker SR, Swanson NA: Local Flaps in Facial Reconstruction. St. Louis, MO, Mosby, 1995 Jackson IT: Local Flaps in Head and Neck Reconstruction. St. Louis, MO, Mosby, 1985
AAOMS • 2008
S233 Contemporary Rhinoplasty for the Oral and Maxillofacial Surgeon Faisal A. Quereshy, DDS, MD, Cleveland, OH Rhinoplasty procedures have been primarily developed and studied by other surgical colleagues. Traditional techniques for cosmetic nasal surgery have included open and closed approaches to the intra-nasal structures. Only within the last two decades have more oral and maxillofacial surgeons incorporated aesthetic nasal surgery into their practices. The objectives of this course will review internal and external nasal anatomic relationships, preoperative patient selection with an emphasis on data collection and treatment planning; discussion of the various surgical approaches including the surgical sequence, precise surgical techniques; and finally the post-surgical care and evaluation including the prompt recognition and management of potential complications. Upon completion, the skilled surgeon can quickly integrate the rhinoplasty – nasal reshaping procedure – as a stand alone procedure in their facial cosmetic surgery practice. References Kennedy BK: Fonseca Oral & Maxillofacial Surgery Vol. 6. “Cosmetic Rhinoplasty” Philadelphia, WB Saunders, 2000, p. 203 Waite PD: Atlas of Oral and Maxillofacial Surgery Clinics of NA. Rhinoplasty 3:2 Philadelphia, WB Saunders, 1985 Epker BN: Esthetic Maxillofacial Surgery “Septorhinoplasty”. Malvern, Lea & Febiger, 1994, p 167-242
S234 Principles for the Revision of Total Alloplastic TMJ Prostheses Louis G. Mercuri, DDS, MS, Maywood, IL It has been almost four decades since Sir John Charnley reported successful total alloplastic joint reconstruction in the orthopaedic surgery literature. The evolution of surgical techniques, implant materials and implant designs have all led to excellent long-term results in older, less active individuals. Survival rates exceeding 90% after 10 years are reported. Encouraged by these results, orthopaedists have widened the indications for total joint replacement increasing the number being implanted in young and middle-aged active patients. Just as the modern practice of reconstructive orthopaedic joint surgery would be unthinkable, so should it be with reconstructive oral and maxillofacial surgery when it comes to the temporomandibular joint. 155