Developing standardized outcomes and algorithms of treatment is a constantly evolving task. This article examines four variables in this process: cleft type, operative technique, surgical experience, and timing. Input from international cleft lip and palate programs regarding techniques and treatment modalities provide a dynamic tool for assessment and the development of guidelines in the treatment of the cleft lip and palate patient.
Development of the iliac crest microsurgical free flap has significantly enhanced the surgical restoration of the mandible. A decade of heavy clinical use has established the versatility and efficacy of this technique. A recent literature review suggests a 96% success rate has been achieved. This donor site provides a long vascular pedicle, appropriately shaped bone, skin, and soft tissue. These properties enable tailoring of the flap to precisely fit the defect. The flap has overcome bone size and movement restrictions imposed by regional pedicles. The retained blood supply induces rapid fracture-like healing and provides metabolic independence from the recipient bed. Incorporating an internal oblique muscle island enhances flap utility. The muscle provides a source of oral lining and sanctions the reconstruction of compound defects with a single flap. In an effort to refine the bony component and reduce donor site …
This patient needed reconstructive surgery following the excision of an acoustic neuroma. See the difference after undergoing masseter-to-facial nerve transfer and cross face nerve grafting.