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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Microvascular free flap reconstruction versus palatal obturation for maxillectomy defects
Mauricio A Moreno1, Roman J Skoracki, Ehab Y Hanna
1Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Head & Neck
|November 11, 2009
Summary
For moderate maxillectomy defects, palatal obturators and microvascular free flaps offer comparable outcomes. Extensive defects benefit more from free flap reconstruction for improved function.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Oncology
Background:
- Palatal obturators and microvascular free flaps are common treatments for maxillectomy defects.
- The optimal reconstruction method remains a subject of debate.
Purpose of the Study:
- To compare the functional outcomes of palatal obturators versus microvascular free flaps in maxillectomy patients.
- To evaluate the impact of defect size on reconstruction choice and outcomes.
Main Methods:
- Retrospective analysis of 113 patients with maxillectomy defects due to cancer.
- Comparison between 73 patients treated with obturators and 40 treated with free flaps.
Main Results:
- Speech intelligibility and diet were similar between groups for moderate defects.
- Free flap reconstruction showed superior outcomes for extensive (>50%) palatal defects.
- No significant difference in the time to local recurrence diagnosis between the two groups.
Conclusions:
- Both obturators and free flaps are viable for moderate maxillectomy defects.
- Free flaps provide better functional results for extensive defects.
- Free flap reconstruction does not appear to delay the diagnosis of local recurrence.