Maxillary reconstruction with free iliac crest flap in a pediatric patient: long-term results

The maxillary bones are a part of the midfacial skeleton and together with the overlying soft tissues are responsible to a large extent for facial contour. For large maxillectomy defects, reconstruction with distant tissues becomes essential for obtaining good and long-lasting results. The aim of this report is to highlight the long-term result on iliac crest free-flap containing anterior–superior iliac spine growth center for maxillectomy defect reconstruction in a pediatric patient. We present a case report of a patient that was first referred to our department at the age of 8, with a recurrent maxillary juvenile ossifying fibroma diagnosis and two previous resection surgeries. A wide maxillary resection was conducted and the myosseous free iliac crest flap was the selected technique to achieve three-dimensional maxillary reconstruction, providing enough bone for palate and maxillary arch reconstruction and consequently an implant-retained prosthesis. Overall good facial symmetry was obtained at early and long-term follow-up. Normal craniofacial development is dependent on the relationships between the mandible and maxilla, and so pediatric facial bone reconstruction that maintains bone structure balance may prevent facial growth–related asymmetries. Level of evidence: Level IV, therapeutic study