Reconstruction of Mid-Facial Defect after Maxillectomy with Free Tissue Transfer / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Postoperative defects of nasal cavity cancer are difficult to reconstruct because of its large and complicated defects. Large defects of the head and neck are challenging to reconstruct since there may be a 3-dimensional requirement of both volume and multiple surfaces of oral lining and external skin. SUBJECTS AND METHOD: We conducted a retrospective review of 14 patients who underwent reconstruction between 1999 and 2007. Outcome measures included free flap types, flap success and post-operative functional result. RESULTS: The anterolateral thigh flap method was used in 7 of the 14 patients (50%), the rectus abdominis free flap method in 4 patients (28%), the fibular osteocutanoeus free flap method in 2 patients (14%) and the radial forearm free flap method in 1 patient (7%). The free flap survival rate was 100 percent with partial flap necrosis in one patient. Return to regular diet was seen in 9 patients (64%), a soft diet in 3 (21%), and a liquid diet in one (7%). Speech was accessed as normal in 8 patients (57%), near normal in 5 (36%), intelligible in one patient (7%). CONCLUSION: Free tissue transfer provides the most effective and reliable form of immediate reconstruction for mid-facial defect after maxillectomy.