Reconstruction of orbital floor and maxilla with divided vascularised calvarial bone flap in one session

SummaryWe present four cases which underwent reconstruction of orbital floor and anterior maxillary wall with a vascularised bone flap following partial maxillectomy. After tumour resections, superficial temporal artery (STA) and vein based calvarial bone flaps from the outer tabula were prepared. Without disrupting the integrity of fascia and periosteum, the bone was separated into two segments in the same direction as the blood flow and one is 3 cm and the other 5 cm. The two bone segments were transferred as one single flap and one segment of the flap was used to reconstruct the orbital floor and the other for reconstruction of the anterior maxillary wall. Since two cases had large skin defects, lateral frontal skin to which the frontal branch of the STA supplies blood was incorporated into the flaps. Functional and aesthetic results were satisfactory at the end of 8–20 months follow-up. This technique allowed reconstruction of the orbital floor and anterior maxillary wall and even skin defects with a single pedicled flap in one session.