Reconstruction of midfacial defects after surgical resection of malignancies.

Midfacial and orbital defects after ablative oncologic surgery are difficult problems for the reconstructive surgeon. Our goal is to address the devastating functional and aesthetic consequences of these extirpations and to improve the quality of life for this unfortunate group of patients. Partial maxillectomy defects are best treated by skin grafting the residual cavity and reconstructing the maxillary defect by prosthetic means. Local tissues can be used when the defects are small and the bone loss is not extensive. For massive midfacial defects with insufficient bony support for prosthetic reconstruction, osseocutaneous free flaps have proved useful to restore contour and the necessary structural support.