Planning orofacial reconstruction with prefabricated composite grafts in noma-surgery
Patients who survive noma develop a mutilated and disabled face. Intense scarring leads to disfigurement and restriction of jaw movement. The defects extend to nearly all aspects of the face, i.e. facial soft tissue, skull and teeth. Comprehensive treatment of this condition requires restoration of the bony framework with dental implants in order to provide mechanical stability and oral function, as well as full-thickness coverage of the defect and a durable inner lining for the oral and paranasal cavities. Prefabricated complex transplants are able to meet these needs for a complete state-of-the-art reconstruction. In practice this advanced surgical concept requires most precise three-dimensional computer-assisted radiographic analysis and planning with stereolithographic models set-up in an articulator. Only now due to complex pre-surgical planning reconstruction using prefabricated composite transplants achieves a greatly improved flap design, which undoubtedly allows these grafts to represent the highest standard in plastic reconstructive surgery.
C. Schaudy, K.-J. Kulenkampff, J. Holle, K. Vinzenz