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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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[A new classification of maxillary defect and simultaneous accurate reconstruction]
1Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Summary
This study proposes a new classification for maxillary defects, guiding the selection of preferred flaps for reconstruction. The approach achieved high success rates, improving patient function and aesthetics.
Area of Science:
- Plastic Surgery
- Maxillofacial Surgery
- Oncology
Background:
- Maxillary defects require complex reconstruction.
- Current classifications may not fully guide flap selection.
- Optimizing functional and aesthetic outcomes is crucial.
Purpose of the Study:
- To propose a novel classification system for maxillary defects.
- To identify preferred flap types for each defect class.
- To evaluate reconstruction outcomes.
Main Methods:
- Retrospective review of 219 patients undergoing maxillary defect reconstruction (2005-2018).
- Classification of defects into four types (I-IV) based on location and extent.
- Evaluation of flap survival, functional recovery (swallowing, speech), aesthetics, and survival rates for malignant tumors.
Main Results:
- A total of 234 repairs were performed using various flaps including fibula, temporal muscle, anterolateral thigh, and rectus abdominis.
- Local pedicled and free flaps demonstrated high success rates (95.6% and 95.8%, respectively).
- Thrombosis was the primary cause of repair failure (4.3%). High patient satisfaction reported for appearance and visual field.
Conclusions:
- A new classification system for maxillary defects facilitates optimal flap selection.
- The proposed classification aids in achieving good functional and aesthetic results.
- This approach enhances patient quality of life following maxillary reconstruction.
