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[Midface reconstruction with free flaps]
M A Germain1, G Demers, G Mamelle
1Département de chirurgie cervicofaciale, institut Gustave-Roussy, Villejuif, France.
Chirurgie; Memoires De L'Academie De Chirurgie
|August 3, 1999
Summary
Microsurgical free flap reconstruction effectively restores midface defects, improving function and aesthetics. This approach offers optimal outcomes for patients with complex facial injuries or cancer.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Midface defects result from cancer, trauma, or congenital issues.
- Reconstruction aims to restore contour, function (respiration, speech, etc.), and support.
Purpose of the Study:
- To evaluate the efficacy of microsurgical free flap reconstruction for midface defects.
- To assess functional and aesthetic outcomes post-reconstruction.
Main Methods:
- Retrospective analysis of 65 patients (1988-1997) with midface defects.
- Reconstruction utilized various free flaps (forearm, latissimus dorsi, scapula, etc.).
- Flaps were chosen for specific midface components: cheek, nose, orbit, palate.
Main Results:
- Low post-operative mortality (1.5%) and manageable morbidity (18.7%).
- Good to excellent aesthetic and functional results in 53 patients.
- Significant improvements in oral intake, speech, and employability (80%).
Conclusions:
- Microsurgical free flaps provide optimal functional and aesthetic restoration for midface defects.
- Multidisciplinary team approach is crucial for advanced midface cancer patients.
- Microsurgery is the state-of-the-art for extensive midface reconstruction.