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Primary oromandibular reconstruction using free flaps and thorp plates in cancer patients: a 5-year experience
Tito Poli1, Silvano Ferrari, Bernardo Bianchi
1Division of Maxillo-Facial Surgery-University Hospital of Parma, Via Gramsci, 14-43100 Parma, Italy.
Background:
Low-profile second-generation THORP titanium plates combined with soft tissues free flaps (forearm or TRAM) can be used for oromandibular reconstruction in patients with SCC in advanced stage (stage III-IV).
Methods:
To evaluate long-term stability and possible complications of this reconstructive technique, we recorded, retrospectively, data of 25 patients with posterolateral oromandibular defects after tumor resection collected during a 5-year period.
Results:
All free flaps were successfully transferred, although eight patients were initially seen with delayed hardware-related reconstructive complications: plate exposure in four patients and plate fracture in four patients.
Conclusions:
Nowadays, the state-of-the-art treatment for mandibular defects is primary bone reconstruction with bone free flaps, but in selected cases (elderly patients, poor performance status, posterolateral oromandibular defects, soft tissue defects much more important than bone defects) the association with THORP plate-soft tissue free flaps represents a good reconstructive choice.