Medial Femoral Condyle Free Flap for Premaxillary Reconstruction in Median Facial Dysplasia.

Objective: Median facial dysplasia is a distinct development anomaly of the craniofacial region that is characterized by deficient mid facial structures. Medial femoral condyle free flap could be used as a bony flap, and the unique characteristics of this flap provide the surgeons with the periosteal component as well. In this work, the authors present our experience with a patient of median facial dysplasia with unilateral cleft lip, cleft palate, and premaxillary deficiency. Methods: The patient was diagnosed with median facial dysplasia accompanied by unilateral cleft lip, cleft palate, and premaxillary. She had presented with severe midface hypoplasia with missing premaxillary bone. Premaxillary reconstruction was performed with the use of medial femoral condyle free flap. Results: Medial femoral condyle free flap was successfully used for premaxillary reconstruction. The flap fitted well to the alveolar bony gap. Since the flap is a periosteal bone flap, the gingival mucosa was reconstructed very well. The lip harmony was considerably restored compared with the preoperative status. Conclusions: Although several other options are available, the medial femoral condyle free flap is particularly suited for the reconstruction of median facial dysplasia. (C) 2016 by Mutaz B. Habal, MD.

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