Secondary ZIP Flap to replace obturator

Institut Gustave Roussy Villejuif

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Defect Classification Brown Class 2b
Flap Type Radial Forearm Flap
Radiotherapy Post-op Radiotherapy

Clinical Notes

Case of a 75-year-old patient with maxillary resection for squamous cell carcinoma and no reconstruction. Patient with an obturator prosthesis. We performed a ZIP flap with immediate loading. This allowed us to close the oronasal communication and restore masticatory function.

Pre-op maxillary defect
Pre-op maxillary defect
pre-op removable obturator
pre-op removable obturator
Zygomatic implant placement
Zygomatic implant placement
radial forearm flap harvest
radial forearm flap harvest
Perforated flap inset
Perforated flap inset
Healed maxilla with implant retained bar
Healed maxilla with implant retained bar
Final prosthesis
Final prosthesis
healed radial forearm donor site
healed radial forearm donor site
Pre-op maxillary defect