Reconstruction of Maxilla and Midface with Microvascular Free Flaps / 대한이비인후과학회지

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.