Reconstruction of Complete Bilateral Maxillary Defects With Free Flaps

J Craniofac Surg. 2022 Sep 1;33(6):e550-e552. doi: 10.1097/SCS.0000000000008399. Epub 2021 Dec 2.

Abstract

Reconstruction of complete bilateral maxillary defects (CBMDs) can be challenging due to the extensive loss of bone and soft tissues. This is a retrospective case series of 46 consecutive patients with CBMDs that were reconstructed with different micro-vascular free flaps. The authors aimed to evaluate the surgical outcomes and discuss the different reconstruction options in this case series. Thirty-six patients underwent reconstruction following ablation surgery for malignant tumors, 6 for benign tumors, 3 patients were treated for osteomyelitis, and 1 patient underwent free flap reconstruction for posttraumatic defects. Free fibula flap (n = 26) is the most commonly used reconstruction method in this case series, which was used in all defect types. This is followed by anterolateral thigh flap (n = 10), 5 rectus abdominis myocutaneous free flap, 3 radial forearm free flaps, and 2 composite free flaps. In this series, 44 free flaps survived, whereas only 2 flaps were lost. All patients could resume a soft diet postoperatively. Reconstruction of CBMDs with vascularized free flaps is a safe and reliable procedure.

MeSH terms

  • Free Tissue Flaps*
  • Humans
  • Maxilla
  • Osteomyelitis* / etiology
  • Plastic Surgery Procedures* / methods
  • Retrospective Studies