Osteocutaneous radial forearm free flap with islanded bony segments for maxilla reconstruction: A case report

Maxillofacial LeFort 1 surgery is a widely used procedure for correcting midface deformities, but it can occasionally result in rare and destructive complications such as non-union of osteotomy gaps and maxillary necrosis. Addressing these complications requires careful consideration of their severity, the surgeon's expertise, and the patient's desired outcomes. Comprehensive imaging, a detailed surgical history, and thorough preoperative planning are essential. We present the case of a 61-year-old Caucasian male referred to the otolaryngology – head and neck surgery clinic for bilateral oroantral fistulas, with multiple failed repair attempts following LeFort I osteotomy for midfacial deformity correction. Reconstruction was performed using an osteocutaneous radial forearm free flap with two separate osteotomy segments to fill the bony defect and seal the fistulas, resulting in full resolution of symptoms. • Free flap with islanded bony segments to reconstruct bilateral maxillary defects. • Free flap to repair bilateral maxillary osteomyelitis and bilateral oroantral fistulas. • Fixing a rare complication of bilateral oroantral fistulas from LeFort 1 surgery