CASE REPORT 2

A 36 YEAR OLD MALE PATIENT REPORTED TO THE DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY WITH THE CHIEF COMPLAINT OF INABILITY TO OPEN AND CLOSE THE MOUTH AND DIFFICULTY IN CHEWING FOOD. HE GAVE A HISTORY OF ROAD TRAFFIC ACCIDENT 2 MONTHS BACK IN WHICH HE HAD LOST HIS RIGHT SIDE MAXILLA AND WAS TREATED FOR FRACTURE OF RIGHT ZMC BY ORIF UNDER G.A IN A PRIVATE HOSPITAL.

HE THEN REPORTED TO OUR DEPARTMENT WHERE MICRO-VASCULAR RECONSTRUCTION WITH FIBULA GRAFT WAS PLANNED FOR THE RECONSTRUCTION OF PALATE AND MAXILLA ON RIGHT SIDE. HE ALSO HAD LEFT PARASYMPHYSIS FRACTURE AND MALUNITED LEFT CONDYLE. A TEAM OF EMINENT SURGEONS INCLUDING DR.

SATYAJIT DANDAGI, DR. DAYASHANKARA RAO J.K., DR. HARSH JAIN ALONG WITH OUR STAFF PERFORMED THIS CHALLENGING SURGERY.

PRE-OPERATIVE PICTURES

FRONTAL VIEW	INTRA-ORAL VIEW	3D CT SCAN

OPERATIVE PROCEDURE

THE PATIENT WAS OPERATED FOR MICRO-VASCULAR RECONSTRUCTION OF MAXILLA USING FIBULA GRAFT ALONG WITH FIBULAR ARTERY, VEIN AND PART OF SKIN OVER THE LEFT FIBULA. AFTER HARVESTING FIBULA ALONG WITH THE ARTERIAL AND VENOUS SUPPLY, IT WAS ANASTOMOSED WITH FACIAL ARTERY AND VEIN IN THE NECK REGION AND THE SKIN WAS USED FOR RECONSTRUCTION OF PALATE ALONG WITH THE BONE. THE SKIN GRAFT WAS HARVESTED FROM THE RIGHT THIGH REGION FOR COVERING THE DONOR SITE ON LEFT LEG.

PATIENT WAS ALSO OPERATED AT THE SAME TIME FOR MALUNITED CONDYLE LEFT SIDE ALONG WITH THE FRACTURE OF THE LEFT PARASYMPHYSIS.

INTRA-OPERATIVE PICTURES

SURFACE MARKING FOR FIBULA GRAFT  FIBULA GRAFT HARVESTED	ANASTOMOSIS IN NECK (RT. SIDE)    SKIN GRAFT

POST-OPERATIVE PICTURES

FRONTAL VIEW	INTRAORAL VIEW

IMMEDIATE POST-OPERATIVE RESULTS ARE PROMISING. PATIENT IS SATISFIED WITH THE TREATMENT. HE IS UNDER OBSERVATION AND FOLLOW-UP PHASE.