Maxillary reconstruction using a horizontally placed iliac crest flap

High maxillectomy defects with preservation of the orbital contents are disabling and tend to cause ocular problems because of the lack of support. Reconstruction should provide support to the orbital contents, restore facial symmetry, and eliminate the oronasal fistula. A wide range of flaps have been described for the reconstruction of these challenging defects. We used a horizontally placed deep circumflex iliac artery free flap with internal oblique muscle in four patients. This is a reliable method, the flap is easy to harvest, and the donor side is minimized by using only the inner table of the iliac crest.