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Updated: Apr 18, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
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Challenges in the reconstruction of bilateral maxillectomy defects
Shawn T Joseph1, Krishnakumar Thankappan2, Rahul Buggaveeti1
1Assistant Professor, Department of Head and Neck Surgery, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Summary
Reconstructing bilateral maxillectomy defects is crucial for function and appearance. Bony reconstruction, often with fibula free flaps, yields satisfactory outcomes despite initial challenges.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Plastic Surgery
Background:
- Bilateral maxillectomy defects pose significant esthetic and functional challenges if not properly reconstructed.
- Adequate reconstruction is vital for restoring quality of life after maxillectomy.
Purpose of the Study:
- To evaluate the outcomes of reconstruction for bilateral maxillectomy defects.
- To assess the efficacy of various flap types in restoring function and appearance.
Main Methods:
- Retrospective case series analysis of 10 patients undergoing bilateral maxillectomy reconstruction.
- Evaluation of defect components, flap types used (14 flaps total), flap loss, and functional outcomes (diet, speech, dental rehabilitation).
Main Results:
- Fibula free flaps were most common among 10 bony and 4 soft tissue flaps used.
- Initial free flap success rate was impacted by defect complexity, with 3 total flap losses.
- Functional evaluation in 7 patients showed improved oral diet (6/7) and intelligible speech (all).
Conclusions:
- Reconstruction is essential for managing bilateral maxillectomy defects, with bony reconstruction being ideal.
- The fibula free flap is a frequently utilized option, though initial success rates can be low.
- Secondary reconstructions and overall satisfactory functional outcomes are achievable.
