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Free-flap mandibular reconstruction: a 10-year follow-up study
David A Hidalgo1, Andrea L Pusic
1Division of Plastic Surgery, Cornell University Medical College, New York, NY, USA. hidalgod@drdavidhidalgo.com
Plastic and Reconstructive Surgery
|July 27, 2002
Summary
Free-flap reconstruction offers excellent long-term functional and aesthetic outcomes for mandibular defects. Bone resorption is minimal, and patients achieve stable results a decade after surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic and Reconstructive Surgery
- Oncology
Background:
- Free-flap reconstruction is the standard for oncologic mandibular defects.
- Long-term outcomes of these reconstructions are not well-established.
Purpose of the Study:
- To evaluate functional and aesthetic results a decade after free-flap mandibular reconstruction.
- To assess long-term complications and bone stability.
Main Methods:
- Retrospective review of 82 patients undergoing free-flap mandibular reconstruction (1987-1990).
- Follow-up interviews and assessments of 20 surviving patients at a mean of 11 years.
- Evaluation of aesthetic outcomes by independent observers and bone resorption via radiographs.
Main Results:
- All flaps survived; 55% had excellent aesthetic outcomes at 10 years.
- 92-93% of mandibular bone height was preserved; resorption was minimal, even with radiation.
- 70% tolerated a regular diet, and speech was generally intelligible.
Conclusions:
- Free-flap mandibular reconstruction yields excellent, stable functional and aesthetic results long-term.
- The procedure demonstrates minimal bone resorption and high patient satisfaction.
- It restores acceptable speech and appearance, with good dietary tolerance and dental rehabilitation options.
