Abstract: Objective To summarize the clinical outcomes of reconstruction of maxillary defects by vascularized tissue flap transfer. Methods Data of 36 patients underwent ablative surgery for maxillary tumor and immediate reconstructive surgery by vascularized tissue flaps in our hospital at August 2012 to December 2018 were retrospectively analyzed. The relationship between the types of the maxillectomy defect and reconstructive options was analyzed. Results According to Brown's Classification, there were 22 cases with class Ⅱb defect, 3 cases class Ⅱc defect, 8 cases classⅡd defect, and 3 cases class Ⅲ b defect. There were 33 cases (91.7%) with class Ⅱ defect in the 36 patients, in which 2 cases were reconstructed by fibula flaps, 17 cases submental island flaps, and 14 cases radial forearm flaps. Vascularized tissue flaps combined with a prefabricated personalized titanium mesh were used for reconstruction of the 3 cases (8.3%) with class Ⅲb defect. The average time of flap harvest was (64±15) min. The mean operation time was (420.6±75.5) min. The mean bleeding volume in operation was (650.5±172.3) mL. The tissue flaps were harvested with the sizes ranging from 4 cm×8 cm to 5 cm×12 cm. All transferred flaps survived completely, and no complete or partial necrosis occurred. The mean follow-up period was (24.5±13.6) months. Of the 36 patients, 3 died including 2 with squamous cell carcinoma (T2N0M0/T3N0M0) and 1 with adenoid cystic carcinoma (T3N0M0), 2 with adenoid cystic carcinoma (T3N0M0) relapsed, and the other 31 survived with tumor-free in the follow-up. None of the cases suffered from oroantral fistula. 88.9% (32/36) of cases were satisfied with their aesthetic outcomes. Good speech outcomes were achieved in 91.7% (33/36) cases. Conclusion An excellent oronasal closure and satisfying aesthetic and speech outcomes could be achieved in cases reconstructed by vascularized tissue flaps for class Ⅱ defect. Tissue flap transfer combined with a prefabricated personalized titanium mesh provide an appropriated option for class Ⅲ defect.

Key words: maxilla, defect, reconstructive surgical procedure, surgical flaps