maxillary reconstruction TRAM Flap



 35 year old diabetic male IDDM who suffered from mucormycosis two years ago ,he under went excision of maxilla,orbit and frontal lobe of brain. Part of nose was also excised , along palate . He had issues of palate which desired reconstruction ,sealing antero medial skull base ,orbital cavity reconstruction.  Patient had unregulated diabetes which needed control.
 Patient was planned for surgery and TRAM flap was planned . After releasing all the contracture and facial vessels were prepared . TRAM flap was harvested and transferred ,palate was reconstructed ,orbital cavity and anterior skull base was sealed.                                







orbital and maxillary defect visible
  

palatal defect

right side nose and nasal septum
                                         
Anterior skull base visible

Anterior skull base visible



Flap inset and vascular ananstomosis 

Flap inseted




post operative flap with monitoring
post operative appearance of flap before skin grafting at day 10








Dr Adhishwar Sharma
MBBS,MS(PGIMER Chd)  ,Mch Plastic Surgery
Fellowship in hand and microvascular surgery
brahmanandclinic,com
8860650846,adhishwar7@gmail.com                                                                                                                                                                                         


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