A modified full‐thickness labial/buccal rotational flap reconstruction technique following bilateral rostral maxillectomy and nasal planectomy for resection of maxillary tumors: Technique and results in two dogs
Panagiotis Kokkinos, James Elliott, José C. Almansa Ruiz- General Veterinary
Abstract
Objective
To describe a naso‐facial reconstruction technique following bilateral rostral maxillectomy and its functional and cosmetic outcomes.
Animals
Two dogs.
Study design
Clinical case series.
Methods
Two dogs were presented with a right rostral maxillary mass. Preoperative biopsy and staging revealed a biologically high‐grade and histologically low‐grade fibrosarcoma (Hi‐Lo FSA). A combined nasal planectomy and radical bilateral rostral maxillectomy was performed sparing the labial/buccal mucocutaneous flaps bilaterally. Surgery resulted in asymmetry of the width of the flaps; the narrower flap was rotated medially to reconstruct the lip and create an oral vestibule. The wider flap was rotated medially to cover the remaining dorsolateral opening of the nasal conchae. The flaps overlapped in a parallel manner, discretely concealing the nasal passages, and separating them from the oral cavity. Hemorrhage occurred in both dogs, with one dog requiring a blood transfusion postoperatively.
Results
Oral Hi‐Lo FSA with tumor‐free margins was confirmed in both dogs. Both dogs recovered uneventfully within 4 weeks. Owners reported being very satisfied with the functional (return to normal exercise/activities and uncompromised respiration) and cosmetic outcomes. Based on the owners' telephone follow up, no tumor recurrence was noted at 15 (Dog 1) and 6 (Dog 2) months postoperatively.
Conclusion
The full‐thickness bilateral labial/buccal rotational flaps were used successfully to reconstruct the rostral maxilla, external nose and facial defects involving the nasal cavity. The technique resulted in acceptable functional and cosmetic outcomes and can be considered for naso‐facial reconstruction in selected cases.