A comparison of radial forearm free-flap reconstruction and non-reconstruction after partial maxillectomy

ObjectiveThis study aimed to compare postoperative outcomes between free-flap reconstruction and prosthesis after secondary healing for moderate-sized maxillectomy defects.MethodsWe enrolled patients who underwent tumor ablation extending to the alveolus, antral walls, masticatory space, and surrounding soft tissue but not the orbital floor with either radial forearm free-flap reconstruction (RFFF) or no reconstruction (NR) and compared the extent of cheek concavity on the resected side, evaluated using axial computed tomography images, and time to prosthesis insertion between the RFFF and NR groups.ResultsThere was a significant difference between the RFFF and NR groups in operative duration (P = 0.010) but not blood loss. The postoperative cheek concavity was significantly smaller in the RFFF group (P = 0.037). Although the between group difference in time to prosthesis insertion was not significant, prostheses tended to be inserted earlier in the RFFF group; median time to prosthesis insertion was 49 days in the RFFF group and 67 days in the NR group.ConclusionsReconstruction of a moderate-sized maxillectomy defect with radial forearm free-flap transfer can improve postoperative outcome.