Chronic Rhinosinusitis Risk after Maxillectomy with Microvascular Reconstruction

Abstract

<b><i>Introduction:</i></b> Chronic rhinosinusitis (CRS) can be associated with tumors involving the maxillary sinus, but outcomes after undergoing maxillectomy with free flap reconstruction remain unclear. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 (<i>p</i> = 0.002) and pre-operative use of sinus medication (<i>p</i> &lt; 0.001). Radiographic evidence of sinusitis 6 months after surgery is also closely associated with sinusitis treatment (<i>p</i> = 0.051). <b><i>Conclusions:</i></b> 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.