title: Benefits of routine maxillectomy and orbital reconstruction with the rectus abdominis free flap.
abstract: Maxillary defects lead to functional and cosmetic deficiencies, especially with tumor invasion of the orbit and cribriform plate. Additionally problematic is the near-total palatal resection in patients with poor dentition (ie, not useful for anchoring obturators) and the desire for return of deglutition and useful speech. A series of 12 patients is presented in whom a rectus abdominis free flap was used for reconstruction of the palate, maxilla, and/or orbit. Nine of 12 free flaps were used to reconstruct defects involving the maxilla and orbit; all were successful in restoring hard palate continuity and function without the use of an obturator. The remaining 3 patients underwent successful repair of defects involving the orbit and medial maxilla without complication. Four of those 9 patients with palatal reconstruction augmented their dental rehabilitation with either their existing upper denture plate or the use of a cosmetic appliance anchored to their remaining dentition. Objectively, the rectus abdominis myocutaneous free flap proved to be a reliable and expeditious method of restoring function and acceptable cosmesis. We believe this technique should be routinely considered in the reconstruction of these defects.
authors.affiliation: Department of Otolaryngology, Wake Forest University Baptist Medical Center, Winston-Salem, NC 27157-1034, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Browne
authors.forename: A J
authors.initials: AJ
authors.lastname: Burke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009915:Orbit / Q000473:pathology / Q000601:surgery*; D010157:Palatal Neoplasms / Q000601:surgery*; D010159:Palate / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps