Stacked fibula flap for unilateral total maxillectomy reconstruction with orbital preservation

Tyler G. Chan, Chris Nickel, Clementino Solares, Rachel Irizarry, Patrik Pipkorn, Harry Michael Baddour, Jennifer H. Gross

Research output: Contribution to journalArticlepeer-review

Abstract

Unilateral total maxillectomy is indicated for locally advanced maxillary tumors that require complete removal of the midface bony structure and inferior orbital rim. Reconstruction of this defect is challenging due to aesthetic and functional concerns. A retrospective review of patients at two tertiary-care institutions undergoing unilateral total maxillectomy reconstruction with a stacked fibula flap from 2018 to 2022 was performed. Each patient's clinical course was reviewed, and attention was focused on the demonstration of surgical steps with photos. Twenty patients underwent stacked fibula flap reconstruction for unilateral total maxillectomy orbital preservation defects. Surgical extirpation was performed for malignancy (80%, 16/20) and for osteoradionecrosis or benign tumor in 20% (4/20). The complication rate was 30% (6/20). Most flaps survived (95%, 19/20). We present a modified, reproducible method of fibula flap reconstruction for unilateral total maxillectomy with orbital preservation that only requires two segments and maintains positive aesthetic and functional results.

Original languageEnglish
Pages (from-to)218-227
Number of pages10
JournalHead and Neck
Volume46
Issue number1
DOIs
StatePublished - Jan 2024

Keywords

  • head and neck reconstruction
  • orbit preservation
  • stacked fibula flap
  • surgical technique
  • unilateral total maxillectomy

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