Changing trends in the microvascular reconstruction and oral rehabilitation following maxillary cancer

SIMON ROGERS*, Ashni Adatia, Stephanie Hackett, Angela Boscarino, Anika Patel, Chris J. Butterworth, Derek Lowe

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

1 Citation (Scopus)
18 Downloads (Pure)

Abstract

Purpose: The maxillectomy defect is complex and the best means to achieve optimal reconstruction and dental rehabilitation is a source of debate. The refinements in zygomatic implant techniques has altered the means and speed by which rehabilitation can be achieved and has also influenced the choice regarding ideal flap reconstruction. The aim of this study is to report on how the method of reconstruction and oral rehabilitation of the maxilla has changed since 1994 in our Institution, and to reflect on case mix and survival.
Methods: Consecutive head and neck oncology cases involving maxillary resections over a 27-year period between January 1994 – November 2020 were identified from hospital records and previous studies. Case note review focused on clinical characteristics, reconstruction, prosthetic rehabilitation, and survival.
Results: There were 186 patients and the tumour sites were; alveolus for 56% (104), hard palate for 19% (35), maxillary sinus for 18% (34) and nasal for 7% (13). 52% (97) were Brown class 2 defects. 45 patients were managed by obturation and 78% (142/183) had free tissue transfer. The main flaps used were radial (52), anterolateral thigh (27), DCIA (22), scapula (13) and fibula (11). There were significant changes over time regarding reconstruction type, use of primary implants, type of dental restoration, and length of hospital stay. Overall survival after 24 months was 64% (SE 4%) and after 60 months was 42% (SE 4%).
Conclusion These data reflect a shift in the reconstruction of the maxillary defect
afforded by the utilisation of zygomatic implants.
Original languageEnglish
Pages (from-to)1-14
JournalEuropean Archives of Oto-Rhino-Laryngology
Early online date1 Feb 2022
DOIs
Publication statusPublished - 1 Feb 2022

Keywords

  • Maxillectomy
  • free tissue transfer
  • reconstruction
  • oral rehabilitation
  • zygomatic implants
  • ZIP Flap

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