OP038: Microsurgical reconstruction of maxilla defects after maxillectomy

Abstract

Background Maxillary defects caused by tumor ablative surgery might lead to deformity of the face and malfunction of mastication, swallowing, phonation and respiration. Microsurgical reconstruction of maxilla is technical challenging and time consuming. The study aims at reporting our experience of maxilla reconstruction using free flaps. Methods We evaluated bony reconstruction after maxillectomy with deep circumflex iliac artery free flap (DCIA) and fibular flap. For fibular flap, preoperative surgical simulation was performed based on CT scans of maxillofacial region and low extremity. Resection template, segmentation template and transfer template were designed and fabricated via rapid prototyping technique. Tumor resection, fibula segmentation and bone graft transfer were performed according to the templates. Results The surgical procedures were all performed successfully. No major post-operative complications were observed. Dental implants were done in selected cases, with satisfactory functional outcome. Conclusion With preoperative surgical simulation, microsurgical reconstruction of maxilla defects with free flap can be accurately performed.