Reconstruction of the midface following tumour surgery

Objectives: To demonstrate the relative benefits of various reconstructive surgical techniques following midface access to the central skull base and following ablation of midface tumours that involve the skull base. Méthodes: Retrospective analysis of variables encountered in the translocation or ablation of various midface structures is presented with options for optimal restoration of form and ophthalmic, nasal and oral function. Included is the use of local tissue, regional flaps and remote microvascular free tissue transfer. Results: An algorithm is presented for optimal flap selection depending on the tissue moved or removed in the midface. Conclusions: Optimal restoration of the midface depends upon the defect created. The skull base team must be able to provide a wide range of local, regional and remote (free) flaps to restore maximal form and function.