title: Microvascular free flap reconstruction versus palatal obturation for maxillectomy defects.
abstract: BACKGROUND
  Palatal obturators and microvascular free flaps are both used to treat patients with maxillectomy defects, however, the optimal technique remains controversial.
  
  
  METHODS
  A retrospective analysis of 113 patients undergoing maxillectomy for cancer was performed. Seventy-three patients received an obturator and 40 patients were reconstructed with a free flap.
  
  
  RESULTS
  Speech intelligibility and postoperative diet were comparable between the obturator and free flap groups, except in cases of extensive (>50%) palatal defects, where free flap reconstruction was superior in both aspects (p = .019 and p = .043, respectively). The average time for presenting with a local recurrence in advanced cancer involving the palate was comparable in both groups (p = .33).
  
  
  CONCLUSIONS
  Moderate-sized maxillectomy defects involving the palate can be successfully treated with either an obturator or free flap reconstruction. Extensive defects have a better functional outcome with free flaps. Evidence does not suggest that free flap reconstructions delay diagnosis of local recurrences.
authors.affiliation: Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Mauricio A
authors.initials: MA
authors.lastname: Moreno
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Skoracki
authors.forename: Ehab Y
authors.initials: EY
authors.lastname: Hanna
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hanasono
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003679:Deglutition; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010158:Palatal Obturators; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013065:Speech Intelligibility; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult