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Reconstructive and prosthodontic outcomes after multiple palatomaxillary reconstructions.

Kayvon F Sharif1, John R Sims2, Lauren E Yue1

  • 1THANC (Thyroid, Head and Neck Cancer) Foundation, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York.

The Laryngoscope
|December 31, 2019
PubMed
Summary
This summary is machine-generated.

Some patients need repeat palatomaxillary reconstruction for cancer recurrence or functional issues. This study details management for these complex cases requiring multiple surgeries.

Keywords:
Palatomaxillaryfree flapfunctionalreconstructionrecurrence

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Plastic Surgery
  • Oncology

Background:

  • Major palatomaxillary reconstruction is complex.
  • A subset of patients require additional surgeries to achieve oncologic and reconstructive goals.

Purpose of the Study:

  • To detail unique management considerations for patients needing multiple palatomaxillary reconstructions.
  • To analyze reasons for and outcomes of repeat palatomaxillary reconstructions.

Main Methods:

  • Retrospective review of patients who underwent palatomaxillary reconstruction between 1998 and 2016.
  • Analysis of reasons for subsequent reconstructions and types of procedures performed.

Main Results:

  • Twenty-one patients required multiple reconstructions, with a median of 17 months to the second procedure.
  • Common reasons for repeat surgery included recurrent disease (10/21), functional/aesthetic issues (7/21), and osteoradionecrosis (4/21).
  • A total of 27 reconstructions were performed, utilizing soft tissue free flaps, vascularized bone free flaps, and locoregional flaps.

Conclusions:

  • Palatomaxillary reconstruction can present unique oncologic and reconstructive challenges.
  • Long-term follow-up may necessitate multiple procedures to optimize outcomes.
  • This study is the first to detail the reasons for and outcomes of multiple reconstructive procedures in this patient population.