{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:30:03Z","timestamp":1747150203846,"version":"3.40.5"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Microvascular free tissue transfer is routinely used for reconstructing midface defects in patients with malignancy, however, studies regarding reconstructive outcomes in invasive fungal sinusitis (IFS) are lacking. We aim to describe outcomes of free flap reconstruction for IFS defects, determine the optimal time to perform reconstruction, and if anti\u2010fungal medications or other risk factors of an immunocompromised patient population affect reconstructive outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of reconstruction for IFS (2010\u20132022). Age, BMI, hemoglobin A1c, number of surgical debridements, and interval from the last debridement to reconstruction were compared between patients with delayed wound healing versus those without. Predictor variables for delayed wound healing and the effect of time on free flap reconstruction were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients underwent free flap reconstruction for IFS. Three patients were immunocompromised from leukemia and 21 had diabetes mellitus (DM). Patients underwent an average of four surgical debridements for treatment of IFS. The interval from the last IFS debridement to flap reconstruction was 5.58\u2009months (\u00b15.5). Seven flaps (25.9%) had delayed wound healing. A shorter interval of less than 2\u2009months between the last debridement for IFS and reconstructive free flap procedure was associated with delayed wound healing (Fisher Exact Test <jats:italic>p<\/jats:italic>\u2009=\u20090.0062). Other factors including DM, BMI, HgA1c, and bone reconstruction were not associated with delayed wound healing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with maxillectomy defects from IFS can undergo microvascular\u2010free flap reconstruction with good outcomes while on anti\u2010fungal medication. Early reconstruction in the first 2\u2009months after the last IFS debridement is associated with delayed wound healing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:1642\u20131647, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31081","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T13:17:33Z","timestamp":1695993453000},"page":"1642-1647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Microvascular Free Flap Outcomes in Maxillectomy Defects from Invasive Fungal Sinusitis"],"prefix":"10.1002","volume":"134","author":[{"given":"Shilpa M.","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-5961","authenticated-orcid":false,"given":"P. 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Reed","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio A.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jumin","family":"Sunde","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor B.","family":"Cave","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Mayo Clinic Arizona  Scottsdale Arizona 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