Boneless Maxillary Reconstruction

Abstract

Objective: Although the midface is supported by maxillary bone, reconstruction of maxillary bony defects does not always require osseous reconstruction. A series of maxillary facial defects of moderate to severe sizes (Brown and Shaw 4-6) uniformly reconstructed with myocutaneous free flaps is presented.

Methods: Retrospective analysis was done for consecutive 10 cases between 2013-18. Seven of the cases had defects caused by oncological resection and 3 defects caused by trauma. Free vertically oriented rectus abdominis (fVRAM) flap was used to reconstruct these defects.

The mean age of patients was 42.9 years (range=20-71 years). All flaps survived and 2 flaps had small skin island problems. Rapid recovery, low morbidity, acceptable oral competency, and satisfactory cosmetic appearance were obtained with the reconstruction using fVRAM flaps.

Conclusion: According to our limited experience, acceptable reconstruction of extensive maxillary defects can be done with using only soft tissue flap, which is versatile and safe.