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Updated: May 20, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Reconstruction of orbitomaxillary defects
1Division of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL 32209, USA.
Summary
Reconstruction of large orbitomaxillary defects using perforator flaps offers predictable outcomes. Patients with larger defects were more satisfied with reconstruction compared to obturation alone.
Area of Science:
- Plastic Surgery
- Maxillofacial Surgery
- Oncology
Background:
- Orbitomaxillary defects pose significant challenges for patients and surgeons.
- Limited high-level evidence exists to guide treatment decisions for these complex reconstructions.
Purpose of the Study:
- To present a single-surgeon's 6-year experience with orbitomaxillary reconstruction.
- To offer insights into treatment strategies for large orbitomaxillary defects (Classes III-VI).
Main Methods:
- Retrospective chart review of 21 patients undergoing orbitomaxillary reconstruction.
- Data included demographics, surgical methods, pathology, and adjuvant radiotherapy.
- Inclusion criteria: initial maxillectomy with orbital involvement, adequate follow-up, and complete records.
Main Results:
- Majority of defects were Brown Class III-VI, primarily due to squamous cell carcinoma.
- Various flap reconstructions were utilized, including radial forearm, anterolateral thigh, and perforator flaps.
- 14 patients were alive without disease at a mean follow-up of 24.5 months.
Conclusions:
- Patients with larger orbitomaxillary defects (Classes III-VI) reported higher satisfaction with reconstruction compared to obturation.
- Perforator flaps provide more predictable outcomes than musculocutaneous flaps due to reduced atrophy.
- Dental implant interest was limited by out-of-pocket costs in this patient population.
