title: Incidence and management of rhinosinusitis after complex orbitofacial reconstruction.
abstract: OBJECTIVE
  To examine the sinus-related sequelae of free flap reconstruction for complex orbitofacial defects.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Demographic, clinical, and radiographic data on a series of 55 patients who had undergone free tissue transfer for orbitofacial reconstruction was retrospectively reviewed. Follow-up of ≥ 3 months was available for 49 patients. Outcome measures studied included clinical or radiographic evidence of sinusitis and the need for sinus surgery.
  
  
  RESULTS
  The most commonly involved sinuses were the ethmoid (n = 40) and maxillary (n = 38) sinuses, and the anterolateral thigh was the most common flap used (n = 41). Clinical and/or radiographic sinusitis was evident in 21 patients (43%), and 10 patients (20%) required sinus surgery at some point during follow-up. Involvement of multiple sinuses in the initial orbitofacial surgery was associated with a significantly increased need for subsequent sinus surgery (P = 0.009). Adjuvant radiotherapy and adjuvant chemoradiotherapy were associated with a significantly increased risk for the development of rhinosinusitis (P = 0.045 and 0.016, respectively).
  
  
  CONCLUSIONS
  Rhinosinusitis and the need for operative management of sinus obstruction are common in patients having undergone complex orbitofacial reconstruction. Careful management of the paranasal sinuses is an important component of the multidisciplinary treatment of such patients.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery (W.J.P., G.G.N., R.N.H., M.R.R., J.M.C.), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.
authors.forename: William J
authors.initials: WJ
authors.lastname: Parkes
authors.forename: Gurston G
authors.initials: GG
authors.lastname: Nyquist
authors.forename: Christopher
authors.initials: C
authors.lastname: Rizzi
authors.forename: Sarah
authors.initials: S
authors.lastname: Zhang
authors.forename: James J
authors.initials: JJ
authors.lastname: Evans
authors.forename: Ryan N
authors.initials: RN
authors.lastname: Heffelfinger
authors.forename: Marc R
authors.initials: MR
authors.lastname: Rosen
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Curry
mesh_terms: D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012220:Rhinitis / Q000453:epidemiology* / Q000628:therapy*; D012852:Sinusitis / Q000453:epidemiology* / Q000628:therapy*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Rhinosinusitis; free tissue transfer; orbitofacial; skullbase