Microvascular free flap reconstruction versus palatal obturation for maxillectomy defects
✍ Scribed by Mauricio A. Moreno; Roman J. Skoracki; Ehab Y. Hanna; Matthew M. Hanasono
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 379 KB
- Volume
- 32
- Category
- Article
- ISSN
- 1043-3074
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✦ Synopsis
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).
Conclusion.
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. © 2009 Wiley Periodicals, Inc. Head Neck, 2009