Maxillary tumours and bilateral reconstruction of the maxilla

Reconstruction of maxillectomy defects following intraoral tumour excision presents a challenge to the plastic surgeon. The defect left after maxillectomy requires a formal reconstruction in order to minimize problems associated with speech and swallowing. A multidimensional approach is required to achieve a structural and functional restoration. The maxillectomy defects are complex, which often requires composite tissue replacement. A variety of reconstructive techniques have been used for the repair of the maxillary and palatal defects, including prosthetics, skin grafts, local and free flaps using the iliac crest, scapula, fibula, latissimus dorsi, radial forearm and abdominis rectus free flaps. We have used a lateral-arm osteocutaneous free flap for reconstruction of a bilateral maxillary defect, with excellent aesthetic, functional and structural support results. This type of reconstruction for this defect has never been reported previously.