Background and objectives: The development of reconstructive surgery has changed the objectives in maxillary reconstruction to get optimal aesthetics and functional results. Methods We analysed all patients treated with reconstructive surgical techniques from 2008 to 2012 in our Department. We reviewed the complications and the characteristics of the patients.

Results: We analysed 10 patients with an average age of 49.3 years, 6 male and 4 female. 4 patients presented squamous cell carcinoma, 4 patient presented other malignant tumours, 1 patient had a giant cell granuloma and we used fibula free flap to close an orosinusal communication. The rate of global complications was 30%, due to, 3 partial necrosis of the skin paddle. According to the Brown and Shaw classification, the most frequent maxillary defect was type IIB.

Conclusions: There is not a perfect flap for complex maxillary defects. With composite free flaps we achieve the best aesthetics and functional results because they holds mimic muscles of the face and allow dental rehabilitation. Fibular osteocutaneous flap is an excellent option for the most of the maxillary defects with better results than other composite free flaps.

Key words: maxillary neoplasms; free tissue flaps; fibula/transplantation; reconstructive surgical procedures