Objective This trial was aimed at investigating the effects of progressive functional training on hip mobility, lower-limb stability, quality of life, and hip complications in patients who have undergone jaw defect reconstruction using vascularized iliac flaps. Methods Patients who underwent reconstruction surgery with vascularized iliac flaps were randomly divided into control and training groups. The control group, according to routine nursing practice, only received activity and safety guidance after the operation. The training group received progressive functional training for functional exercise. The primary outcomes were donor area function-Harris hip score and the timed “Up and Go” test. Secondary outcomes were patients’ quality of life, the hip visual analog scale, and other complications. Observations and evaluations were performed before the surgery and on postoperative day 7 and at months 1, 3, 6, and 12. Results The donor area function and quality of life of the patients in the training group were significantly improved at 1, 3, 6, and 12 months after surgery, and the differences were statistically significant. The load-dependent pain in the training group was significantly reduced compared with that in the control group. The incidence rates of gait disturbance at postoperative months 3, and 6 in the training group were significantly lower than the corresponding rates in the control group (P < 0.05). Conclusion Progressive functional training can accelerate the restoration of hip function and stability of lower-limb movement, alleviate gait disorders, relieve pain, and improve patients’ quality of life.

OBJECTIVE:To evaluate the clinical outcomes and define the indications for a one-stage mandibular reconstruction technique that combines iliac bone flaps with immediate implant-based dentures, and to assess both the accuracy of surgical planning and the long-term success of the procedure. METHODS:A total of ten patients underwent the procedure at Peking University Hospital of Stomatology between June 2020 and August 2023. The preoperative biopsy pathology of all the patients confirmed a benign tumor. In this technique, iliac bone flaps were used for mandibular reconstruction, and immediate implant-based dentures were placed during the same surgical session. Various outcome measures were evaluated, including the accuracy of the surgical reconstruction, implant placement deviations (entry point, apical point, depth, and angle), and long-term outcomes, such as cervical bone resorption, implant survival, and the cumulative survival rate. RESULTS:Thirty-eight implants were successfully inserted into the iliac flaps of the ten patients. The median follow-up duration was 23.5 months, and no significant complications occurred during the follow-up period, such as infections, titanium plate exposure, implant loosening, or damage to the implants and dentures. The accuracy of preoperative virtual surgical planning (VSP) was highly reliable. The repeatability of the VSP model compared to the postoperative reconstructed mandible was as follows: 67.82% ±10.16% within 1 mm, 82.14% ±6.58% within 2 mm, and 90.61% ±4.62% within 3 mm. The average maximum deviation from the plan was (6.10±0.89) mm, with an average overall deviation of (1.14±0.31) mm. For the implants, deviations in critical parameters were as follows: entry point deviation was (2.02±0.58) mm, apical point deviation was (2.25± 0.66) mm, depth deviation was (1.26±0.51) mm, and angular deviation was 1.84°±1.10°. The implant survival rate remained 100% during the follow-up, with a cumulative survival rate of 97.37% from 1 to 4 years. Average cervical bone resorption was 0.94 mm. CONCLUSION:The combination of iliac bone flaps with immediate implant-based dentures for one-stage mandibular reconstruction demonstrated pro-mising clinical outcomes, including high implant survival and minimal complications. This technique proved to be safe and reliable for mandibular reconstruction. However, further studies with larger sample sizes and longer follow-up periods are necessary to confirm the long-term efficacy and optimal indications for this procedure.

Vascularised iliac flaps (VIFs) are widely used for the reconstruction of jawbone defects; however, postoperative donor-site complications, such as gait disturbances, with an incidence of 13.9-50%, significantly impede patient recovery. Despite this, evidence-based rehabilitation protocols specific to VIFs remain lacking. Existing rehabilitation guidelines for hip surgeries are unsuitable owing to differences in surgical mechanisms. This study employed the Delphi method, engaging 20 multidisciplinary experts (oral and maxillofacial surgery: 5; orthopaedics: 7; rehabilitation: 6; nursing: 2). Through three rounds of anonymous consultations, and by integrating literature evidence with postoperative mobility assessments, we developed a phased, individualised progressive functional training (PFT) protocol featuring dynamic evaluation, coordinated activation of abdominal and hip muscle groups, and safe exercise strategies during head and neck immobilisation, while overcoming conventional hip rehabilitation limitations (e.g., restrictions on flexion < 90°, and bans on squatting or cross-legged sitting). PFT is structured into six progressive phases, with exercise intensity tailored to assessment outcomes. A single-centre randomised controlled trial (n = 62) demonstrated that PFT significantly accelerated lower limb functional recovery, improved hip mobility and balance, reduced donor-site pain, and enhanced quality of life (University of Washington Quality of Life questionnaire: F (1,60) = 17.262, P < 0.001), without increasing the risk of flap vascular compromise or iliac hematoma. The limitations of the study include the single-centre design and lack of cross-cultural validation. Future multicentre studies are required to enhance adaptability. This study establishes a foundational yet effective framework for post-VIF rehabilitation, guiding clinical practice and research advancements.

Background One-stage jaw reconstruction with fibular flap and prosthetic rehabilitation restores bony and dental continuity simultaneously. It was also called as “jaw-in-a-day (JIAD)” technique. However, bone volume and height of fibular flap may be insufficient for dental implant insertion. The provision of a considerable amount of bone makes an iliac flap the ideal choice in these cases. We present the first case report to document the use of one-stage jaw reconstruction and prosthetic rehabilitation with the iliac flap. Case presentation We modified the conventional JIAD workflow to make it suitable for iliac flap. Two cases were presented who both underwent segmental mandibulectomy for ameloblastoma. Virtual surgical planning was performed in all cases. The iliac crest was positioned upward to provide cortical bone for achieving primary stability of dental implants. Similar to the “all-on-4” procedure, the iliac bone was placed 12 to 15 mm below the occlusal plane to create adequate space for the implant-retained prosthesis. Immediate implant-based dental rehabilitation was performed at same stage. The surgery was successful in all cases without any short-term complications. In the first postoperative week, patients were given a liquid diet through a nasal feeding tube. The liquid diet is advised until 1 month after the surgery. Thereafter, a soft diet is recommended. Patients were advised to resume routine mastication and normal diet 3 months after the surgery. Peri-implantitis occurred in one patient, and additional gingival graft was required. Postoperative function and esthetics were satisfactory at the last follow-up visit. Conclusions One-stage jaw reconstruction and prosthetic rehabilitation with the iliac flap are safe and useful for restoring postoperative function and esthetics. It should be used in more cases with a longer follow-up in further studies.

Objectives/hypothesisEarly mobility following vascularized iliac flap (VIF) may be influenced by several factors. This study evaluated early mobility and factors influencing patient mobilization following VIF.Study designProspective observational studyMethodsWe recruited 115 inpatients who underwent VIF surgery for jaw defect reconstruction at our hospital. Sociodemographic, clinical, and Tinetti test data were analyzed using univariate and multiple logistic regression. Receiver operating characteristics (ROC) curves were used to analyze factors hindering early mobilization.ResultsThe proportion of patients who could sit up on POD2 and walk on POD3 was 61.74% and 56.52%, respectively. The mean Tinetti score at discharge was 9.56 ± 4.27 (range, 3–22). Logistic regression analysis revealed five significant indicators associated with delayed mobilization: pain (odds ratio [OR] = 0.396, p = 0.010), soft tissue flap area (OR = 0.818, p = 0.012), length of bone harvested (OR = 0.443, p = 0.009), and fatigue (OR = 0.449, p = 0.030). The area under the ROC curve for the five indicators was 0.964, with a cutoff value of 22.108, sensitivity of 0.940, specificity of 0.846, and Youden's index of 0.786. The length of bone harvested (B = −0.696, p < 0.001), soft tissue flap area (B = −0.103, p = 0.039), and fatigue (B = −0.628, p = 0.009) influenced the Tinetti test at discharge.ConclusionsMore than half of the patients could be mobilized early. Pain significantly influenced mobilization progress, followed by soft tissue flap area, length of bone harvested, and fatigue.

BACKGROUND:The purpose of this study was to investigate the effect of anterior superior iliac spine (ASIS) preservation on donor site morbidity and function after harvesting a vascularized iliac bone flap (VIBF).METHODS:Patients who underwent jaws reconstruction with VIBF were divided into a maintaining the anterior superior iliac spine (MASIS) group and a not maintaining the anterior superior iliac spine (NMASIS) group. Pain, tenderness, sensory deficit, gait disturbance, and function of the donor site were evaluated before and after the operation.RESULTS:Thirty-three patients were included in this study, of which 18 were in the MASIS group. The incidence of sensory deficit in the MASIS group was significantly lower than that in the NMASIS group (50.0% vs. 86.7%, p = 0.010). Pain, tenderness, gait disturbance, and function did not differ statistically between the two groups.CONCLUSION:Except for sensory deficit, ASIS preservation has minimal impact on donor site morbidity and function.

Background The present study aimed to investigate oral cancer awareness and its related knowledge among residents in Beijing. Methods A questionnaire survey was conducted among Beijing residents concerning their knowledge of oral cancer, and its prevention and treatment. Results A total of 3055 questionnaires were completed, 45.8% by males and 54.2% by females. The ages of the respondents ranged from 15 to 93 years; 12.4% were smokers, 1.1% chewed betel nuts, and 82.5% brushed their teeth at least twice a day. Lung cancer was heard of by the most respondents, followed by gastric cancer and liver cancer; oral cancer was the least heard of. More than 60% of respondents were unaware of the risk factors and early signs of oral cancer. Conclusions This survey demonstrated a general lack of public awareness and knowledge about oral cancer. Specific measures should be taken to improve public awareness of oral cancer and its prevention and treatment.

The study aims to compare differences among iliac bone flaps with different iliac crest orientations for the repair of mandibular defects with an aim to analyze their advantages, disadvantages, and effects. Clinical data and computed tomography scans of all patients who underwent iliac bone flap repair of the mandible in Peking University School and Hospital of Stomatology from January 2016 to April 2021 were collected. Patients were divided into the iliac crest towards alveolar process (Group A) and the iliac crest towards mandibular inferior margin (Group B). Software was used to measure corresponding indicators. The results obtained for the groups were statistically analyzed. The study included 78 patients (25 and 53 in groups A and B, respectively). The symmetry of the LC-type defect was better in group A (p < 0.05). The all-bone width of the alveolar process side in group A was greater than 6 mm; in 15 cases of group B, the width was less than 6 mm (p < 0.05). The intermaxillary distance of two sites were higher in group B (p < 0.05). The bone cortical thickness was significantly thicker in group A (p < 0.05). One year after the mandibular body defect was reconstructed with a vascularized iliac bone flap, the iliac crest towards alveolar process group showed better bone symmetry, width, intermaxillary distance, and cortical thickness to meet the planting requirements. The use of an iliac crest towards alveolar process may be a better approach for mandible reconstruction.

Objective:To summarize and evaluate the target and dose design of 125I seed brachytherapy treatment plan of pediatric borderline tumor in head neck region. Methods:Eleven patients underwent definitive 125I brachytherapy or combined with surgery in Peking University Hospital of Stomatology from January 2010 to December 2018 were retrospective analyzed. The target region was set by extending the tumor gross region by 0.5 to 1.0 cm. The prescription dose and activity ranged from 80 to 120 Gy and 18.5 MBq, respectively. The treatments were performed according to the plan under general anesthesia. Response and toxic reaction were recorded during follow-up. The preoperative and postoperative dosimetric results were compared; and the local control rate, objective response rate, complete response rate and acute toxic reaction rate were calculated. Results:There was no statistically significant difference between preoperative and postoperative dosimetric results ( P>0.05). The follow-up time ranged from 33 to 131 months, with a median of 48 months. The local control rate, objective response rate, complete response rate and acute toxic reaction rate were 100%, 100%, 71.4% and 81.8%, respectively. Conclusions:Under well-designed target and dose, 125I brachytherapy for treatment of pediatric borderline tumor in head neck region would bring ideal therapeutic and toxic outcomes, and could be regarded as a feasible therapy.

PURPOSE:The present study retrospectively evaluated the effectiveness and safety of iodine-125 interstitial brachytherapy for treatment of primary locally advanced adenoid cystic carcinoma (ACC) of the base of tongue (BOT).MATERIAL AND METHODS:This study was a retrospective analysis of data of 19 patients with ACC, who were treated with iodine-125 interstitial brachytherapy between March 2008 and April 2018. Overall survival (OS), disease-free survival (DFS), local control (LC), and radiation-related toxicities were determined. Factors affecting the outcomes were evaluated.RESULTS:Six males and 13 females were included in our study, with a median follow-up time of 35 months. 3- and 5-year OS rates were 71.5% and 47.6%, respectively. 3- and 5-year LC rates were 88.5% and 34.5%, respectively. 3- and 5-year DFS rates were 54.7% and 21.9%, respectively. A significant difference was observed in patients with or without brain metastases for OS rate. No severe acute toxicity was observed, while severe late toxicity was observed in one patient.CONCLUSIONS:The results suggest that iodine-125 interstitial brachytherapy is an effective and safe option for the treatment of primary locally advanced ACC of the base of the tongue, with reasonably satisfactory LC and OS.

Purpose: Distant metastasis (DM) indicates a poor outcome from cancer treatment. The present study estimated the incidence of DM and identified risk factors associated with development of DM in patients with salivary gland carcinoma that achieved locoregional control after surgery combined with 125I internal brachytherapy. Materials and Methods: A retrospective cohort study was performed using consecutive patients treated with surgery combined with 125I internal brachytherapy at the Peking University School and Hospital of Stomatology. Variables that might be associated with DM, including clinical, treatment characteristics, pathologic findings, and time to DM were recorded. Kaplan-Meier was performed to estimate incidence of DM, and Cox proportional hazard model was used to identify factors associated with DM. Results: Data from 156 patients were obtained for statistical analysis. The DM was observed in 16 of 156 with rate being 10.3%. The median interval from diagnosis of primary tumor to DM was 30.0 months. The 3-, 5-, 10-year overall survival rates were 97.0, 94.6, 85.2%, respectively, for patients without DM compared with 60.9, 52.2, 26.1%, respectively, for those with DM (P < .001). Univariate analysis revealed that the factors that significantly influenced DM were primary tumor site (P = .012) and histologic grade (P = .001). Multivariate Cox proportional hazard model indicated that histologic grade was the most important risk factor for predicting the risk of DM (P = .005; hazard ratio: 2.79; 95% confidence interval: 1.36 to 5.72). Conclusions: Histologic grade was the major risk factor that significantly influenced DM in patients with salivary gland carcinoma that achieved locoregional control. Patients with high-grade tumors should be under close evaluation for DM. (C) 2021 American Association of Oral and Maxillofacial Surgeons

Objective. The aim of this study was to investigate the effectiveness and safety of surgery combined with I-125 seed brachytherapy for treatment of carcinoma ex pleomorphic adenoma (CXPA) of the parotid gland and to identify the factors associated with prognosis. Study Design. We conducted a retrospective analysis of data of patients with CXPA of the parotid gland treated with surgery plus 125 I seed brachytherapy at the Peking University School of Stomatology Hospital between December 2003 and July 2018. Results. Fifty-five patients (median age, 51 years) were included in the study. Median follow-up was 50.5 months. The 3-, 5-, and 10-year overall survival rates were 91.1%, 91.1%, and 81.5%, respectively. The 3-, 5-, and 10-year local control rates were all 85.2%. Grades 1-3 adverse effects occurred in 22 patients; no grade 4 reactions occurred. T stage, N stage, tumor invasiveness, perineural invasion, and surgical margins significantly affected local control rates. Lymph node metastasis and perineural invasion were independent predictors of poor local control. Lymph node metastasis was an independent predictor of poor survival. Conclusions. Surgery plus I-125 seed brachytherapy appears to be an effective and safe treatment for CXPA of the parotid gland. T stage, N stage, tumor invasiveness, and perineural invasion are factors influencing prognosis.

Objective Midface reconstruction is challenging for functional and esthetic reasons. The present study analyzed the effect of virtual surgical planning (VSP) of the deep circumflex iliac artery (DCIA) flap for midface reconstruction. Patients and Methods Thirty-four patients who underwent midface reconstruction with the DCIA flap were included in this retrospective study. Of the 34 patients, 16 underwent preoperative VSP, which used a three-dimensionally printed surgical guide, computer-assisted navigation system, and pre-bent titanium implants to transfer VSP into real-world surgery. The other 18 patients underwent traditional midface reconstruction. The following were compared between the two groups: bony contact rate in the buttress region (BCR), dental arch reconstruction rate (DAR), surgical approach, position of vascular anastomosis, and dental implantation rate. The independent-samples t-test and Fisher’s exact test were used for analysis. P < 0.05 was considered statistically significant. Results In total, 12 males and 22 females were included in this study. All patients underwent midface reconstruction using the DCIA flap at the same institution. The median age of patients was 33 years (range: 16–68 years). The average BCR and DAR values in the VSP group were 59.4% ± 27.9% and 87.5% ± 18.9%, respectively, which were significantly higher compared with the non-VSP group (P = 0.049 and P = 0.004, respectively). The dental implantation rate in the VSP group (50.0%) was significantly higher compared with the non-VSP group (11.1%; P = 0.023). The intraoral approach for tumor ablation and vascular anastomosis was the most frequent choice in both groups. There was no significant difference between the two groups. All patients were satisfied with facial symmetry postoperatively. Conclusions VSP could effectively augment the effect of midface reconstruction with the DCIA flap. Stronger bone contact in the buttress region and higher DAR provide more opportunity for dental implantation, which might be the best solution to improve masticatory function in patients with midface defects.

目的:通过比较髂骨嵴不同朝向重建下颌骨缺损后的对称性和是否符合种植牙治疗标准,分析血管化髂骨瓣重建下颌骨有牙区缺损时髂骨嵴不同朝向的优缺点.方法:回顾2017年1月—2019年12月于北京大学口腔医院行髂骨瓣重建下颌骨缺损的患者的基本信息和术后CT资料,根据髂骨嵴的朝向分为髂骨嵴朝向牙槽突组和髂骨嵴朝向下颌骨下缘组.CT影像资料导入Proplan软件,测量2组髂骨重建后的对称性;导入Simplant软件,测量髂骨骨块长度,相对于患侧上颌1、3、6牙3个位点对应的髂骨高度、牙槽突侧骨宽度以及颌间距离.采用SPSS 25.0软件包对数据进行统计学分析.结果:30例患者纳入研究,每组各15例,平均年龄37.7岁.LC缺损类型在颏孔点下缘位置朝向牙槽突组非对称率(4.9％)显著小于朝向下颌骨下缘组(18.2％,P<0.05).朝向牙槽突组和朝向下颌骨下缘的骨长度分别为(49.43±4.17)mm、(52.25±3.79)mm(P=0.102).相对于患侧上颌1、3、6位点的牙槽突侧髂骨骨宽度朝向牙槽突组分别为(11.40±0.63)、(12.15±0.46)、(13.15±0.62)mm,均显著大于朝向下颌骨下缘组的(7.93±0.55)、(8.97±0.34)、(8.70±0.49)mm(P<0.05);相对于上颌6位点的髂骨骨高度在朝向牙槽突组为(29.80±1.17)mm,显著大于朝向下颌骨下缘组的(25.42±1.17)mm(P<0.05).相对于上颌6位点的颌间距离,朝向牙槽突组为(10.89±1.07)mm,显著小于朝向下颌骨下缘组的(14.33±0.76)mm(P<0.05).结论:在血管化髂骨瓣修复重建下颌骨有牙区缺损时,髂骨嵴朝向牙槽突侧较髂骨嵴朝向下颌骨下缘侧有更好的对称性,更充足的牙槽嵴宽度及更合适的颌间距离.

Objective:To analyze the target design and dosimetric parameters of patients with recurrent adenoid cystic carcinoma (ACC) in the parotid gland who were treated with 125I interstitial brachytherapy alone. Methods:A retrospective analysis was conducted for 25 patients with recurrent adenoid cystic carcinoma in parotid gland who were histopathologically diagnosed between January 2015 and October 2019. These patients were treated with 125I interstitial brachytherapy alone, with prescribed doses of 100-120 Gy. The target volume was designed according to the pathological characteristics of ACC and recurrence sites. The pre- and post-operation dosimetric parameters (i.e., local control rates) were calculated using the treatment planning system. Results:In this study, the local recurrence sites included the superficial lobe (10/25) and deep lobe (7/25) of the parotid gland primarily and the skull base region (four patients) and mastoid posterior region (four patients) secondarily. The number of 125I seeds ranged from 16 to 111, with a median number of 59. The activity of radioactive particles was 18.5-25.9 MBq. The 3- and 5-year local control rates were 81.5% and 61.5%, respectively. No significant differences were found between pre- and post-operative dosimetric parameters such as D90, V100, and V150. There was no significant difference in local control rates among the four different recurrence sites. Conclusions:125I interstitial brachytherapy is proven to be an effective approach in the treatment of recurrent adenoid cystic carcinoma in the parotid gland. Satisfying local control rates can be achieved through target delineation performed according to recurrence sites and perineural invasion characteristics of ACC.

Objective:To explore and evaluate the accuracy, conformity, and clinical application value of digital surgical techniques in guiding 125I seed implantation in the brachytherapy of deep head and neck tumors. Methods:Twelve patients with deep head and neck tumors who received brachytherapy of radioactive 125I seed implantation were selected for the study.The locations of the implantation needles and seeds were designed based on CT images before the operation.A digital positioning model was built according to the treatment plan to accurately import the planned locations of implantation needles into the surgical navigation system.Meanwhile, an individualized puncture guidance template was designed and printed according to the patients′ facial profiles as well as the locations and directions of the implantation needles.During the operation, the template was put in place under the guidance of the navigation system and meanwhile, the implantation needle puncture and radioactive seed implantation were conducted under the joint guidance of the visual needle path and real-time implantation needle locations in the navigation system and template guidance holes.The locations of the implantation needle and the seeds were validated by CT scan and the dose distribution in target areas was calculated.Adverse reactions such as hematoma, pain, infection, nonunion of puncture sites, and tumor cell implantation were observed during and after the operation. Results:All 12 patients successfully received implantation needle puncture and radioactive seed implantation under the guidance of the digital surgical techniques, achieving excellent effects of real-time visualization guidance.Meanwhile, the locations and number of the implantation needles and seeds were consistent with the treatment plan and were distributed evenly.Furthermore, according to postoperative verification, D90 ranged from 83.7 Gy to 131.0 Gy, with an average of 107.5 Gy; V100 was 89.6%-99.3%, with an average of 94.6%, and V150 ranged from 40.2% to 58.9%, averaging 47.8%.No serious adverse reactions were observed during and after the operation. Conclusions:With digital surgical techniques, the surgical navigation system and 3D-printed individualized puncture guidance template jointly guided the implantation needle puncture and 125I seed implantation, improving the accuracy and conformity of the brachytherapy.Therefore, they have clinical application value in head and neck brachytherapy, especially in deep areas with complex anatomical structures.

Microsurgical reconstruction for anterior maxillary defects presents a surgical challenge. The objective of this study was to ascertain the feasibility of a new series of intraoral surgical approach using deep circumflex iliac artery (DCIA) flap to achieve functional reconstruction for anterior maxillary defects. Two male patients with anterior maxillary defects (Brown Class IC) were treated in this study. Both patients underwent computer-assisted maxillary reconstruction with a DCIA flap (with pedicle positioning laterally to the bony flap) using intraoral anastomosis techniques. The overall DCIA flap survival rate was 100% and mucosa was all healed uneventfully. One patient received dental implantation and loaded with prosthetic superstructures. Both patients were satisfied with their postoperative oral function and appearance. This study illustrated a new and feasible series of surgical design for anterior maxillary bone defect reconstruction with DCIA flaps and intraoral anastomosis assisted by digital techniques.

Background This study aimed to determine the effectiveness and safety of surgery combined with postoperative I-125 seed brachytherapy for treatment of primary mucoepidermoid carcinoma (MEC) of the parotid gland. Methods Retrospective analysis of data of patients with MEC (n = 108) treated with surgery plus postoperative I-125 seed brachytherapy between 2004 and 2016. Overall survival (OS), disease-free survival (DFS), local control rate (LCR), distant metastasis, and radiation-associated toxicities were analyzed, and factors affecting outcomes were evaluated. Results The 5- and 10-year OS were 98.8% and 95.8%, respectively. The DFS and LCR at 5 and 10 years were all 91.4%. Age >= 60 years (hazard ratio [HR] = 6.86, 95% confidence interval [CI]: 1.54-30.55) and T4 disease (HR = 7.15, 95% CI: 1.40-36.52) were poor prognostic factors. Acute radiation-associated toxicities were minor. Conclusion Surgery plus I-125 seed brachytherapy appears to be an effective treatment for parotid gland MEC, capable of providing satisfactory outcomes with few complications.

Maxillary defects result in esthetic and functional defects in patients. Several techniques are available for ma-xillary reconstruction. Herein, we present a case of maxillary reconstruction with medial femoral condyle periosteal flap by intraoral anastomosis. The characteristics of medial femoral condyle periosteal flap and the advantages of intraoral anasto-mosis are introduced.