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An algorithm for maxillectomy defect reconstruction

S P Davison1, D A Sherris, N B Meland

  • 1Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.

The Laryngoscope
|February 24, 1998
PubMed
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Maxillectomy defects disrupt oral and nasal cavities, causing functional deficits. This study outlines reconstruction options, from obturators to free tissue grafts, to guide surgical planning for these complex defects.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Head and Neck Oncology

Background:

  • Maxillectomy defects create oro-nasal communications, potentially involving the orbit.
  • These defects lead to significant functional impairments in deglutition and speech, alongside soft tissue loss.

Purpose of the Study:

  • To define reconstruction options for the full spectrum of maxillectomy defects.
  • To develop a treatment algorithm for presurgical planning in maxillectomy reconstruction.

Main Methods:

  • Review of treatment protocols for 108 maxillectomy patients (Jan 1991-Feb 1996).
  • Description of an 'ascension of care' approach, detailing reconstructive methods used.

Main Results:

Related Experiment Videos

  • A range of reconstructive techniques were employed, including dental obturators, nonvascularized grafts, local flaps, regional flaps, and free tissue grafts (n=28).
  • Data and experience were organized to create a treatment algorithm.

    • Conclusions:

    • A structured approach to reconstruction, progressing from simpler to complex methods, is essential.
    • The developed algorithm aids in presurgical planning for optimal maxillectomy defect reconstruction.