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Soft Tissue Defects:

1.

Describe the palatal island flap.

Reference(s):

Genden, E. M., Lee, B. B., & Urken, M. L. (2001). The palatal island flap for reconstruction of palatal and retromolar trigone defects revisited. Archives of Otolaryngology–Head & Neck Surgery, 127(7), 837–841.

2.

Submental flaps: discuss the anatomy and applications.

3.

Describe the FAMM flap and its applications.

4.

Pectoralis major myocutaneous flap: briefly discuss the procedure and indications for use in oral defects.

5.

Is there a role for sensate free flaps in oral reconstruction?

Reference(s):

Urken, M.L. (1995). The restoration or preservation of sensation in the oral cavity following ablative surgery. Arch Otolaryngol Head Neck Surg, 121(6), 607-12.

Boyd, B, Mulholland, S, Gullane P, Irish J, Kelly L, et al. (1994). Reinnervated lateral antebrachial cutaneous neurosome flaps in oral reconstruction: are we making sense? Plast Reconstr Surg, 93(7), 1350-9.

Hayden, R.E. (1994). Free flap transfer for restoration of sensation and lubrication to the reconstructed oral cavity and pharynx. Otolaryngol Clin North Am, 27(6), 1185-99.

Bony defects:

6.

How do bone grafts heal? What is osteogenesis, osteoconduction, osteoinduction?

7.

Review the commonly used sites for bone graft and their advantages and disadvantages. What graft resorbs the most? How can you prevent this?

8.

What are bone graft substitutes: What are the options?

Reference(s):

Dinopoulos, C. (2013, October). Re: The article “Dinopoulos H, Dimitriou R, Giannoudis PV. Bone graft substitutes: what are the options? Surgeon. 2012 Aug;10(4):230-9. The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. Scotland.

9.

How do you decide when to treat a mandibular defect without reconstruction (swing) vs. a metal plate and soft tissue flap vs. bony reconstruction utilizing a free flap?

10.

Discuss the options for mandibular reconstruction in lateral defects (non-vascularized vs. vascularized bone grafts). Does size matter?

11.

Discuss the options for mandibular reconstruction in anterior arch defects (non-vascularized vs. vascularized bone grafts). Ask Dr. (your microvascular surgeon) what they prefer and why.

12.

Discuss distraction osteogenesis in mandibular reconstruction.

13.

Discuss challenges specific to reconstructing the temporomandibular joint.

14.

You are reconstructing a 4 cm mandible defect in a bilateral amputee. What are your options?

15.

Provide the group with an update on the future of mandibular reconstruction.