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Oromandibular reconstruction with simultaneous free flaps: experience on 10 cases
1Division of Maxillo-Facial Surgery, University of Parma, Italy. bbianchi@ao.pr.it
Summary
Double free flap reconstruction effectively addresses extensive oral cancer defects, achieving 100% flap survival and improved patient diet. This technique offers good aesthetic and functional outcomes for complex oro-mandibular reconstructions.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Oncology
- Reconstructive Microsurgery
Background:
- Advanced oral cancer (T4 squamous-cell carcinoma) often results in extensive composite defects requiring complex reconstruction.
- Traditional reconstructive methods may be insufficient for massive oro-mandibular defects, necessitating innovative surgical approaches.
Observation:
- This study reports on the double free-flap technique for reconstructing large, complex defects in 10 patients with T4 oral squamous-cell carcinoma.
- Various combinations of free flaps were utilized, including fibula osteo-cutaneous, fibula osseous, and iliac crest flaps, with forearm free flaps consistently used for intra-oral reconstruction.
Findings:
- The study achieved 100% total flap survival in all 10 patients.
- All patients successfully regained adequate oral diet post-reconstruction.
- At a mean follow-up of 36 months, 40% of patients were still alive, indicating potential long-term survival benefits.
Implications:
- Simultaneous double free flap reconstruction is a viable and effective option for selected patients with massive oro-mandibular defects.
- This technique can lead to satisfactory aesthetic and functional results, improving quality of life after extensive cancer surgery.
- The findings support the consideration of this approach in managing complex reconstructive challenges in advanced oral cancer treatment.