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November 1992

Oronasal Reconstruction With Local Mucoperiosteal and Free Latissimus Dorsi Flaps

Author Affiliations

From the Department of Otolaryngology, University of Iowa, Iowa City (Dr Hoffman), and the Departments of Pediatrics, Pulmonary Division (Dr Jalowayski), and Surgery, Division of Head and Neck Surgery, University of California, San Diego (Drs Robbins and Feldman).

Arch Otolaryngol Head Neck Surg. 1992;118(11):1238-1241. doi:10.1001/archotol.1992.01880110106019

• We describe the use of maxillary sinus mucoperiosteum as a pedicled flap to reconstruct the floor of the nose following resection of cancer involving the palate, buccal mucosa, and mandible. Complete inferior turbinectomy allows access to the roof of the maxillary sinus to harvest the mucoperiosteum as a vascularized flap pedicled under the remaining middle turbinate. A free latissimus dorsi myocutaneous flap suspended from the floor of the orbit and nasal septum is then used to obliterate the maxillary sinus, reconstruct the palate, and support the floor of the nose. A reconstruction employing this combination of flaps is presented, including postoperative endoscopic intranasal photography and magnetic resonance imaging. Despite the elevated level of the floor of the nose and the absence of the inferior turbinates, rhinomanometry performed 3 months postoperatively demonstrates adequate nasal airflow with normal responses to nasal decongestants.

(Arch Otolaryngol Head Neck Surg. 1992;118:1238-1241)

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