Chronic Rhinosinusitis Risk after Maxillectomy with Microvascular Reconstruction

ORL J Otorhinolaryngol Relat Spec. 2024;86(3-4):124-131. doi: 10.1159/000539604. Epub 2024 Jul 1.

Abstract

Introduction: Chronic rhinosinusitis (CRS) can be associated with tumors involving the maxillary sinus, but outcomes after undergoing maxillectomy with free flap reconstruction remain unclear.

Methods: A retrospective analysis of medical records was performed to evaluate evidence of CRS in patients who underwent maxillectomy with free flap reconstruction at a single tertiary care academic institution from 2013 through 2020.

Results: Eighty-four patients were assessed. Nineteen (22.6%) patients were diagnosed with CRS after surgery, 23 (27.4%) patients were treated for sinus symptoms, and 49 (58.3%) had radiographic evidence of sinus inflammation for more than 6 months. Risk factors for requiring sinus treatment included adjuvant or neoadjuvant chemotherapy (p = 0.002) and pre-operative use of sinus medication (p < 0.001). Radiographic evidence of sinusitis 6 months after surgery is also closely associated with sinusitis treatment (p = 0.051).

Conclusions: CRS may be underdiagnosed in patients undergoing maxillectomy with microvascular reconstruction. Further evaluation into patient sinus disease and symptoms following neoplastic surgery may lead to a higher quality of life in some long-term survivors.

Keywords: Chronic rhinosinusitis; Maxillary cancer; Maxillectomy; Microvascular reconstruction; Outcomes.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Female
  • Free Tissue Flaps*
  • Humans
  • Male
  • Maxilla / surgery
  • Maxillary Sinus / diagnostic imaging
  • Maxillary Sinus / surgery
  • Maxillary Sinus Neoplasms / surgery
  • Middle Aged
  • Plastic Surgery Procedures* / adverse effects
  • Plastic Surgery Procedures* / methods
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Rhinitis* / surgery
  • Rhinosinusitis
  • Risk Factors
  • Sinusitis* / surgery