Reconstruction of maxillectomy defects with free flaps--comparison of immediate and delayed reconstruction: a retrospective analysis of 51 cases.
To establish a standard reconstructive material we compared outcomes after immediate and delayed reconstruction. Of the 21 patients who had immediate reconstruction, six patients had upper horizontal plane reconstruction. All bone grafts survived without infection or absorption. Of the 30 patients who had delayed reconstruction, 22 patients had upper horizontal plane reconstruction, with vascularised bone in 14 patients, non-vascularised bone or cartilage in five patients, and hydroxyapatite bone block in three. Postoperative infections developed in three of four patients for whom costal cartilage was used, and in all three patients for whom hydroxyapatite blocks were used. Non-vascularised bone or cartilage grafts are preferable for immediate reconstruction because of their technical simplicity. Vascularised bone grafts or osteocutaneous flaps are preferable for delayed reconstruction, however, as in most cases the operating field is contaminated by bacterial.
Takushima
Akihiko
A
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyorin University, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan. takushima-pla@umin.ac.jp
Harii
Kiyonori
K
Okazaki
Mutsumi
M
Ohura
Norihiko
N
Momosawa
Akira
A
Asato
Hirotaka
H
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery; D019291:Skull Base / Q000601:surgery; D013524:Surgical Flaps; D013997:Time Factors