Reconstruction of maxillofacial defects: A retrospective institutional study

Abstract

This study aims to evaluate the maxillofacial defects and the types of flaps employed to reconstruct the lost framework of head and neck among patients treated in our institution. This hospital-based retrospective study was done at the Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, Tamil Nadu, from the case record of patients who underwent resection followed by reconstruction for various pathologies from July 2019 to March 2020. Consecutive case records of all the patients who had reconstructive surgeries for maxillofacial defects were included in the study. Various parameters of the patients were retrieved from the patient digital data registry and recorded. All patients underwent surgeries for defects in the maxillofacial region followed by reconstruction. Descriptive statistics and a regression model were used to assess the relationship between the site of defect and the type of flap used. Pearson’s chi square test was done to test the association between categorical variables.The study was analysed using the IBM Statistical Package for the Social Sciences (SPSS) Statistics, version 20.0 and results obtained. A total of 47 patients aged more than 6 years were studied, with the average age being 51.68 +/-13.4 years. In our study out of 47 patients, 11 were female and 36 were male. Majority of patients who underwent surgery belonged to 41-60 years of age followed by 61-70 years of age. 89.4% of patients underwent surgery for oral Squamous cell carcinoma which included both males and females. A statistically significant association between the type of defect encountered and the reconstructive technique employed was present. Chi square test; p<0.001. Within the limits of this study, the predominant pathology for which resection is carried out among patients is oral squamous cell carcinoma which is seen mostly in the middle aged group. Males were mostly affected by pathology than females. Reconstructive surgery with flaps is the most common type of management. Free fibula flap was 9.31 times more likely to be employed for defects in the mandible. With an increase in complexity and size of the maxillofacial defect, the type of reconstructive surgery also varies.