Deep circumflex iliac artery free flap with internal oblique muscle as a new method of immediate reconstruction of maxillectomy defect

Background A wide range of pedicled and free tissue transfer flaps have been described in the reconstruction of the complex maxillofacial defect, but no preferred reconstructive technique has so far emerged. The previous methods described may effectively close the oronasal fistula but reliable support for the cheek and orbit while providing a basis for an implant retained prosthesis is less likely to be achieved. Methods The methods of using the flap in low, high, and central maxillectomy defects as well as cases requiring orbital exenteration are described. Results and Conclusions The deep circumflex iliac artery (DCIA) flap with internal oblique provides a reliable reconstruction for the maxillectomy as the fistula is closed with muscle which becomes epithelialized with minimal bulk. The large volume of bone available from the iliac crest can restore the facial contour, support the orbital contents, reconstruct the orbital rim, and provide sufficient bulk of bone for the placement of implants. HEAD & NECK 1996;18:412–421 © 1996 John Wiley & Sons, Inc.