COMBINING FREE-FLAP RECONSTRUCTION AND CRANIOFACIAL PROSTHETIC TECHNIQUE FOR ORBIT, SCALP, AND TEMPORAL DEFECTS

Objectives: To identify factors leading to successful application of p rosthetic techniques following free flap reconstruction of the orbit, scalp, and temporal region. Study Design: Retrospective review. Method s: Twenty-eight patients who underwent free flap reconstruction for de fects of these regions between 1989 and 1996 were reviewed for clinica l parameters, flap loss, patient survival, and implant loss rate. Pros thetic usage rates were compared before and after introduction of a si te-specific reconstructive algorithm, Results: Free Bap success rate w as 93%, whereas osseointegrated implant loss rate mas 11%, In addition to implants, a reconstructive strategy that provided thin, vascular t issue between bone and shin, a flat platform in the temporal region, a nd preservation of orbital cavity depth led to increased prosthetic us age. Conclusions: Craniofacial prosthetic techniques can significantly augment the results of free flap surgery for the orbit, scalp, and te mporary region, Successful combination of these techniques requires a site-specific surgical approach.