Maxillary Sinus Mucosa Preservation Versus Mucosal Sacrifice: Radiographic Outcomes After Inferior Maxillectomy and Soft-Tissue Free Flap Reconstruction.

Abstract

This study evaluates the impact of maxillary sinus mucosa preservation on radiographic outcomes after an inferior maxillectomy and soft-tissue free flap reconstruction. A total of 90 patients in two cohorts (mucosal sacrifice versus mucosa preservation) were evaluated from an institutional dataset. Imaging was reviewed at set time points and sinus scores were allotted based on a modification of the Lund-MacKay system. Patients were evaluated for changes in sinus scores. A univariate (UVA) and multivariate (MVA) analysis was performed. In gp1 (mucosal sacrifice), mean postoperative sinus score was 1.21 ± 1.30 (p = < 0.001) at 24 months. On UVA, advanced T-stage at 12 months (OR 7.143, 95% CI 1.484-34.384, p = 0.014) and 24 months (OR 5.500, 95% CI 1.219-24.813, p = 0.027), and on MVA, advanced T-stage were associated with increased odds for higher sinus score (OR 4.993, 95% CI 1.084-22.995, p = 0.039). In Gp2 (Mucosa preserved), the mean postoperative sinus score was 0.31 ± 0.47 (p = 0.021) at 24 months. On UVA and MVA, no predictors were identified for a higher sinus score. Following an inferior maxillectomy and soft-tissue free flap reconstruction, notably reduced sinus scores were seen in patients with preservation of the remaining maxillary sinus mucosa.