A new method of reconstruction in a patient undergoing bilateral total maxillectomy.

A new application of the titanium hollow screw reconstruction plate (THORP) system, originally designed for bridging mandibular defects, is presented. Because of the screw-plate locking principle, the system allows rigid fixation of the plate without unphysiologic load to the bone underneath. A case is presented with a large squamous cell carcinoma requiring bilateral total maxillectomy. The titanium plate was attached horizontally to the zygomatic bones with two titanium hollow screws on each side. Six months later a prosthetic device was constructed and attached to the exposed part of the plate by a modified bar and clips system. The patient is able to speak, chew, and swallow without difficulty.