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Age-Associated Donor-Site Selection Patterns in Pediatric Maxillary Microvascular Reconstruction: A 14-Year
Dominika Lech1, Robert Maksymowicz1, Jeremi Matysek1
1Department of Clinical Pediatrics, Head and Neck Surgery Clinic for Children and Young Adults, University of Warmia and Mazury, 10-709 Olsztyn, Poland.
Journal of Clinical Medicine
|May 27, 2026
Summary
Pediatric maxillary reconstruction patterns adapt with age, favoring soft-tissue flaps for younger children and osseous flaps for older ones. This age-based approach optimizes outcomes for growing patients.
Area of Science:
- Plastic Surgery
- Pediatric Craniofacial Surgery
- Reconstructive Surgery
Background:
- Reconstructing maxillary defects in children poses unique challenges due to craniofacial growth and long-term planning needs.
- Microvascular free-flap reconstruction is used in pediatric head and neck surgery, but maxilla-specific data are limited.
- This study investigates donor-site selection in pediatric maxillary microvascular reconstruction based on patient age.
Purpose of the Study:
- To describe donor-site selection patterns in pediatric maxillary microvascular reconstruction.
- To explore the relationship between donor-site selection and patient age.
- To inform individualized treatment planning for pediatric maxillary defects.
Main Methods:
- Retrospective observational study of pediatric patients (1-18 years) undergoing maxillary microvascular free-flap reconstruction.
- Data collected included patient age, defect characteristics, reconstruction timing, donor-site, and flap survival.
- Nonparametric statistical methods analyzed donor-site selection patterns in relation to patient age.
Main Results:
- Fifty-five pediatric patients were included, with an overall flap survival rate of 81.82%.
- Donor-site selection showed a significant association with patient age (p < 0.05).
- Younger children predominantly received soft-tissue flaps, while older children and adolescents more often received osseous flaps.
Conclusions:
- Pediatric maxillary reconstruction demonstrates an age-adapted pattern, utilizing soft-tissue flaps for younger patients and osseous flaps for older ones.
- These findings highlight developmental differences influencing reconstructive priorities and support individualized planning.
- Age was not significantly associated with total flap loss, though this requires further investigation with larger sample sizes.
