Evidence map›Paper›PMID 42103964›Full record

ArticleOral and maxillofacial surgery2026

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

Felix Neumann, Phillip Gomme, Jakob Fenske, Philipp Lampert, Oliver Wagendorf, Friedrich Mrosk, Elena Hofmann, Susanne Nahles, Max Heiland, Kilian Kreutzer and 3 more

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In one paragraph

Article in Oral and maxillofacial surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Felix NeumannDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. felix.neumann@charite.de.
Phillip GommeDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Jakob FenskeDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Philipp LampertDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Oliver WagendorfDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Friedrich MroskDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Elena HofmannDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Susanne NahlesDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Kilian KreutzerDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Anna-Christina SofroniouDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Christian DollDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Steffen KoerdtDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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

methodsThis 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.

resultsBony (fibula, scapula) and soft tissue (radial forearm, anterolateral thigh) flap techniques were used depending on defect size. Most defects requiring coverage were classified as class II (n = 70, 71.4%; 18 (25.7%) bony vs. 52 (74.3%) soft tissue) or class IV (n = 16, 16.3%; 4 (25.0%) bony vs. 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). Unilateral defects were present in 81 cases (82.7%; 15 (18.5%) bony vs. 66 (81.5%) soft tissue), while bilateral defects were observed in 17 cases (17.3%; 7 (42.2%) bony vs. 10 (57.8%) soft tissue). Postoperative complications were observed in 57 cases (58.2%), predominantly comprising minor issues such as bleeding or wound healing disorders. Major complications, including the need for transplant revisions, occurred in 9 cases (9.2%), with early transplant loss in three instances. No significant correlation was found between transplant loss and defect classification (p = 0.73) or transplant type (p = 0.07). However, bony flaps demonstrated a higher tendency towards flap loss compared to soft tissue flaps (18.2% vs 4.0%). Dental rehabilitation using dental implants was performed in only 18.2% of all patients who received bony reconstruction.

conclusionThe 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. Neither defect size nor transplant type used demonstrated a significant impact, though bony transplants showed a higher tendency towards flap loss. Despite the observed complication rate, free flaps continue to represent a reliable treatment option for patients with midfacial defects. In cases where bony reconstruction is not strictly necessary, dental rehabilitation using patient-specific preprosthetic implants may offer a viable alternative to bone grafts.

Indexed as

Facial NeoplasmsMicrosurgeryPlastic Surgery ProceduresPostoperative ComplicationsSurgical FlapsAdolescentAdultAgedAged, 80 and overBone TransplantationFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeBrown classificationDental rehabilitationHead and neck cancerMicrovascular reconstructionMidface reconstruction

Identifiers

PMID42103964
PMCPMC13156200

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.