Microsurgical reconstruction in midface defects based on defect morphology and size - Reconstruction…

Cohort studyOral and maxillofacial surgery· May 2026

Microsurgical reconstruction in midface defects based on defect morphology and size - Reconstruction techniques, complications, and outcomes.

Felix Neumann, Phillip Gomme, Jakob Fenske … Steffen Koerdt

Microsurgery & FlapsCohort studyTreatmentQ2IF 2.0

Bony free flaps had higher flap loss than soft tissue flaps in midface reconstruction

Microsurgical reconstruction in midface defects based on defect morphology and size - Reconstruction techniques, complications, and outcomes.

Felix Neumann … Steffen Koerdt

Oral and maxillofacial surgery · May 2026 · Q2 in Surgery

Purpose

This study´s aim was to analyse clinical outcomes of microvascular reconstructions performed for malignancy-caused midface defects of varying sizes at our department.

Methods

This retrospective study included 98 patients (38 women; 60 men; age range 16-94 years) who underwent microvascular reconstruction for a malignancy-related midface defect between April 2017 and August 2022.

n = 98 patients

Results

bony flaps failed far more often than soft tissue flaps

Bony flaps

18.2%

Soft tissue flaps

4%

More results

12 (75.0%) soft tissue) according to Brown and Shaw.

The proportion of other horizontal defect classes was significantly lower (n = 12, 12.2%; all soft tissue).

Postoperative complications were observed in 57 cases (58.2%), predominantly comprising minor issues such as bleeding or wound healing disorders.

More results

No significant correlation was found between transplant loss and defect classification (p = 0.73) or transplant type (p = 0.07).

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Conclusion · 1 of 3

The complication rate associated with microvascular reconstructions was relatively high. Most complications were minor and could be managed therapeutically. Major complications, such as flap failure, remained relatively uncommon.

Conclusion · 2 of 3

Neither defect size nor transplant type used demonstrated a significant impact, though bony transplants showed a higher tendency towards flap loss.

Conclusion · 3 of 3

Despite the observed complication rate, free flaps continue to represent a reliable treatment option for patients with midfacial defects.

Microsurgical reconstruction in midface defects based on defect morphology and size - Reconstruction techniques, complications, and outcomes.

Microsurgical reconstruction in midface defects based on defect morphology and size - Reconstruction techniques, complications, and outcomes.

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