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The treatment of patients with advanced head and neck cancers requires an extensive oromandibular and craniomaxillofacial resection in many cases. The reconstruction after these extensive resections presents many challenges to the reconstructive surgical team. The purpose of the reconstruction is not only to rehabilitate the physical facial appearance, but also to rehabilitate function, in order to improve future quality of life. To achieve this goal, the use of free tissue reconstruction is often required. The main challenge with osseous free flap reconstruction of the facial bones is the need of perfect alignment at the defect site. The use of different 3D technologies including computerized models and printed 3D stereolithographic models in the preoperative setting improves the accuracy and the outcome of the reconstruction.

Tumors originating in the maxillary sinus are relativeLy rare. The aim of this article is to review the indications, diagnosis and treatment of patients with maxillary tumors operated at Tel Aviv Sourasky Medical Center during the period 1999 - 2008.A total of 174 patients underwent surgery due to neoplasms originating in the maxillary sinus: 118 patients (68%) had malignant and 54 (32%) had benign tumors.The most common malignancy was squamous cell carcinoma (40%), and the most common benign tumor was juvenile nasopharyngeal angiofibroma (36%). A total of 146 patients (84%) underwent partial maxillectomy and 28 (16%) total maxillectomy. In 9 cases, resection was extended to include the eye socket or base of skull, due to tumor invasion. Thirty-five patients had post-operative complications, with local wound infection being the most common complication (n = 12). Among patients with malignant tumors, 75 are alive without disease (67%), 12 (10%) are alive with disease and 31 (23%) died of disease or other causes.The surgical approach to malignancies of the maxilla is safe and effective. A multidisciplinary team approach is essential to deliver appropriate therapeutic means for these patients.