Reconstruction of Orbital Exenteration and Radical Maxillectomy Defects Using Anterolateral Thigh Free Flap

Abstract

The loss of the eye (globe) and the orbital contents can present significant functional and cosmetic challenges for a patient. When combined with a significant maxillary sinus resection, this can result in a large facial defect for a surgeon to manage. The resulting defect will likely have communication with elements of the oral cavity. It is also possible that such a defect would communicate with the cranial vault that could present additional reconstructive requirements (please refer to the chapters on orbital exenteration and skull base reconstruction). Larger volume reconstructions required to fill the orbit, adjacent maxillary and ethmoid sinuses, and seal closed the skull base and cerebrospinal fluid space (dura) can be challenging. Additionally, the potential for a large skin paddle can allow for facial wound closure and eventual camouflage with an adhesive anaplastic prosthetic.