Korean J Otorhinolaryngol-Head Neck Surg.  2013 Oct;56(10):642-646. 10.3342/kjorl-hns.2013.56.10.642.

Reconstruction of Maxilla and Midface with Microvascular Free Flaps

• Kim SH
• Kim DW
• Kim H
• Kim DY
• Rhee CS
• Hah JH

• KMID: 2277796
• DOI: http://doi.org/10.3342/kjorl-hns.2013.56.10.642

Abstract

BACKGROUND AND OBJECTIVES
The aim of this study is to report the clinical results of maxillary reconstruction with free flap.
SUBJECTS AND METHOD
Patients who had undergone free flap reconstruction after maxillectomy from January 2009 to January 2013 were included in the study. The medical records of the maxillary defect classification, the type of flap used for reconstruction, follow-up results including the survival rate of flap and postoperative complications were analyzed retrospectively.
RESULTS
A total of 13 cases underwent maxillary reconstruction after maxillectomy. Maxillary resection were classified from Ia to V according to the Brown classlification system, and various composite flaps including rectus abdominis, latissimus dorsi, radial forearm and iliac crest were used. One case (class Ia) was reconstructed with a radial forearm free flap while six cases (classes II, III) were reconstructed with the osteomuscular free flap type, such as iliac crest. Another six cases needed orbital exenteration (class IV, V) and were reconstructed with a soft tissue free flap type, such as a rectus abdominis or latissimus dorsi. Of the 13 cases, four patients had postoperative wound dehiscence and two had preoperative radiotherapy. In all 13 cases, the flaps survived.
CONCLUSION
Maxillary reconstructions were performed successfully with various free flaps according to the extent of maxillary defect.

Keyword

Free flap; Iliac crest; Maxillary defect; Maxillectomy; Reconstruction

MeSH Terms

Follow-Up Studies
Forearm
Free Tissue Flaps*
Humans
Maxilla*
Medical Records
Orbit
Postoperative Complications
Rectus Abdominis
Survival Rate