Palatomaxillary reconstruction with titanium mesh and radial forearm flap

ObjectiveThe purpose of this study was to assess the treatment and prognosis of the palatomaxillary reconstruction with titanium mesh and the free radial forearm flap.Study designThis is a retrospective study of 19 patients with palatomaxillary defects who underwent immediate reconstruction using titanium mesh and a radial forearm flap during the 4-year period from 2004 to 2008. Intraoperatively, the titanium mesh was fixed to the residual bones for the reconstruction of hard-tissue defect after the tumor resection; then the free radial forearm flap was harvested to repair the soft-tissue defect, serving as the intraoral lining and titanium mesh covering.ResultsPostoperative esthetic appearance and function were followed-up. All of the patients achieved a satisfactory facial appearance. The speech assessment was good, and the oronasal reflux did not occur in all patients. Only 3 patients had titanium mesh exposure during the follow-up period.ConclusionThe free radial forearm flap with folded titanium mesh is a reliable option for reconstruction of palatomaxillary defects. It is highly effective for swallowing and speech rehabilitation as well as esthetic reconstruction.