Microvascular reconstruction of the orbital complex.

Extensive skin, paranasal, and skull base malignancies often invade the orbit necessitating the removal of the orbital contents to achieve local tumor control. Defects of this region often create a communication between the intracranial and extracranial contents that involves a large volume of skin, soft tissue, and bone. Local and regional tissue alone is rarely adequate to repair these defects. In contrast, free tissue transfer can provide vascularized skin, soft tissue, and bone that can reliably separate the extracranial and intracranial compartments and restore the bony and soft tissue architecture of the orbitomaxillary complex. This article summarizes the approach to orbitomaxillary reconstruction and discusses the use of free tissue transfer in the rehabilitation of this complex region.