Comparative study for closure methods of maxillary defects after maxillectomy, a free flap versus a maxillary obturator

Abstract

ObjectiveReconstruction with a free flap after maxillectomy is not unified, and reconstruction techniques are applied according to the surgeon’s preference. The present study evaluated patient characteristics (sex and age), clinical factors (operation time, bleeding volume, hospitalization, number of remaining maxillary teeth, maxillary defect), and quality of life of patients after surgery who did or did not undergo reconstruction at the time of resection of maxillary malignant gingival tumors. MethodsWe conducted a retrospective case control study. The patient sample consisted of 38 patients who underwent maxillectomy as maxillary gingival malignant tumor ablative surgery between 2007 and 2018. Thirteen patients received reconstruction with a free flap (reconstruction group) and 25 patients received reconstruction with an obturator (non-reconstruction group). Quality of life was assessed using the University of Washington Quality of Life questionnaire (UW-QOL) for patients who were able to respond. There were seven valid responses in the reconstruction group and seven valid responses in the non-reconstruction group. Differences in questionnaire items between groups were evaluated using the Mann–Whitney U test. ResultsThe reconstruction group had significantly longer operation time, larger bleeding volume, and longer hospitalization time than the non-reconstruction group (P < 0.05 for all). However, no significant differences were observed in UW-QOL questionnaire items between the two groups. ConclusionThis study showed that there was no significant difference in postoperative patient QOL between reconstruction and non-reconstruction following maxillectomy.