Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic and Reconstructive Surgery
• Head and Neck Oncology

Background:

• Maxillectomy defects, resulting from cancer resection or trauma, present significant reconstructive challenges.
• Restoration of oral competence, cosmesis, and function is crucial for patient quality of life.

Purpose of the Study:

• To evaluate free flap reconstructive options for partial and total maxillectomy defects.
• To discuss the functional and aesthetic outcomes of these reconstructions.

Main Methods:

• Retrospective review of 58 patients (51 oncologic, 7 trauma) with maxillectomy defects.
• Analysis of various free flaps including fibula, rectus abdominis, scapular, radial forearm, and latissimus dorsi.

Main Results:

• High success rate with only 1 flap failure reported.
• Successful separation of oral and sinonasal cavities in all cases.
• Improved masticatory and phonatory function, with most patients on regular diets and clear speech.

Conclusions:

• Free flap reconstruction provides a reliable, single-stage solution for maxillectomy defects.
• Achieves permanent oral separation, functional restoration (diet, speech), and good cosmetic results.
• Tailored flap selection optimizes outcomes for individual patient needs.