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Ann Plast Surg. 2008 Jan;60(1):49-52. doi: 10.1097/

Le Fort I osteotomy and the use of bilateral bichat bulla adipose flap: an effective new technique for reconstructing oronasal communications due to cocaine abuse.

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Unità Operativa di Chirurgia Maxillofacciale, Università Cattolica del Sacro Cuore, Rome, Italy.


The aim of the study was to describe a new and effective method for reconstructing small- and medium-sized oronasal communications in cases of deficient blood supply of oronasal mucosa.A male patient, aged 45, was presented with a hard palate defect due to chronic cocaine inhalation. The defect was corrected using bilateral Bichat bulla adipose flap and a Le Fort I osteotomy. The surgical technique was described, together with its advantages. Surgery lasted 2 hours. The reconstructive technique had been easy to execute. Six months after the surgery, the defect has been corrected without complications.Le Fort I osteotomy and the use of a bilateral Bichat bulla adipose flap is an effective technique to correct small- and medium-sized palatal defects not solvable with simple oral mucosa flaps. The technique is easy to execute and it showed a high efficacy with minimal impact on the patient's esthetic appearance.

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