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[Vascularized osseous flaps for mandibular reconstruction after osteoradionecrosis].
A Girod1, P Boulétreau, M Freidel
1Service de Chirurgie maxillo-faciale, stomatologie et plastique de la face, CH Lyon-Sud, Pierre-Benite.
Revue De Stomatologie Et De Chirurgie Maxillo-Faciale
|December 17, 2004
Summary
Vascular osseous flaps, particularly fibular free flaps, are reliable for reconstructing mandibular defects caused by osteoradionecrosis. While complications can occur, these methods significantly enhance patients' quality of life.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Oncology
Context:
- Osteoradionecrosis (ORN) frequently necessitates complex mandibular reconstruction.
- Restoring mandibular continuity after ORN presents significant surgical challenges.
- Vascular osseous flaps offer a potential solution for these challenging reconstructions.
Purpose:
- To evaluate the reliability and effectiveness of vascular osseous flaps in mandibular reconstruction following ORN.
- To compare the outcomes of different flap types used for ORN-related mandibular defects.
Summary:
- A retrospective review analyzed 25 mandibular reconstructions in 23 patients with ORN between 1989 and 2002.
- Flap types included fibular free flaps, serrato-costal free flaps, and others.
- Major complications occurred in 8% (two flap losses), with 42% minor complications, but overall quality of life improved.
Impact:
- Fibular free flaps are confirmed as a highly effective method for both immediate and delayed mandibular reconstruction post-ORN.
- Serrato-costal flaps serve as a viable alternative when fibular flaps are not feasible.
- Successful reconstruction significantly improves patient quality of life after ORN treatment.