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<p>To evaluate the clinical outcomes and feasibility of the Zygomatic Implant Perforated (ZIP) flap technique for the primary reconstruction of Brown Class 2 maxillary defects in oral squamous cell carcinoma (OSCC), focusing on early dental rehabilitation, flap viability, and long-term quality of life. This retrospective study was conducted at Sri Shankara Cancer Hospital, Bangalore, from January 2023 to June 2024. Five patients—four with primary OSCC and one with a secondary defect—underwent infrastructure maxillectomy with immediate reconstruction using a radial forearm free flap combined with zygomatic implant placement. Virtual surgical planning sessions guided resection margins and implant positioning. A temporary prosthesis was placed intraoperatively and replaced with a definitive one after completion of adjuvant therapy. Quality of life was assessed using the UW-QOL v4 questionnaire at 1, 6, and 24&#xa0;months. All flaps survived with no need for re-exploration. The facial artery and cephalic vein were the most commonly used recipient vessels. The four primary OSCC cases underwent timely radiation and achieved successful prosthetic integration. The secondary case experienced an orbital floor breach, which was later repaired with titanium mesh. UW-QOL scores showed consistent improvement across functional and psychosocial domains, with most patients achieving near-complete recovery by 24&#xa0;months. No cases of peri-implantitis or donor site morbidity were noted. The ZIP flap technique is a reliable option for single-stage reconstruction of low-level maxillary defects, enabling early fixed dental rehabilitation with sustained functional and aesthetic outcomes. Its use is best reserved for non-irradiated, primary cases, where vascular integrity and tissue quality support optimal results.</p>

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Clinical and Functional Outcomes of ZIP Flaps in Oral Squamous Cell Carcinoma

  • 期刊论文

  • 发表日期：

    2025年10月18日

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  • Radhika Kapahtia,
  • Prajwal Dange,
  • Karthik N. Rao,
  • S. Girish Rao,
  • B. S. Srinath

摘要

To evaluate the clinical outcomes and feasibility of the Zygomatic Implant Perforated (ZIP) flap technique for the primary reconstruction of Brown Class 2 maxillary defects in oral squamous cell carcinoma (OSCC), focusing on early dental rehabilitation, flap viability, and long-term quality of life. This retrospective study was conducted at Sri Shankara Cancer Hospital, Bangalore, from January 2023 to June 2024. Five patients—four with primary OSCC and one with a secondary defect—underwent infrastructure maxillectomy with immediate reconstruction using a radial forearm free flap combined with zygomatic implant placement. Virtual surgical planning sessions guided resection margins and implant positioning. A temporary prosthesis was placed intraoperatively and replaced with a definitive one after completion of adjuvant therapy. Quality of life was assessed using the UW-QOL v4 questionnaire at 1, 6, and 24 months. All flaps survived with no need for re-exploration. The facial artery and cephalic vein were the most commonly used recipient vessels. The four primary OSCC cases underwent timely radiation and achieved successful prosthetic integration. The secondary case experienced an orbital floor breach, which was later repaired with titanium mesh. UW-QOL scores showed consistent improvement across functional and psychosocial domains, with most patients achieving near-complete recovery by 24 months. No cases of peri-implantitis or donor site morbidity were noted. The ZIP flap technique is a reliable option for single-stage reconstruction of low-level maxillary defects, enabling early fixed dental rehabilitation with sustained functional and aesthetic outcomes. Its use is best reserved for non-irradiated, primary cases, where vascular integrity and tissue quality support optimal results.