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Sequential second free bone flaps for reconstruction of metachronous mandibular defects
1Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, California, USA. njones@mednet.ucla.edu
Plastic and Reconstructive Surgery
|September 16, 2005
Summary
This study evaluated bone-to-bone healing in patients requiring two mandibular reconstructions with osteocutaneous free flaps. Solid healing was achieved, improving quality of life, though long-term survival varied.
Area of Science:
- Oral surgery
- Reconstructive surgery
- Oncology
Background:
- Assessing outcomes of secondary mandibular reconstruction using sequential osteocutaneous free flaps in oral cancer patients.
- Evaluating bone-to-bone healing and long-term survival after repeat vascularized bone grafting for recurrent or metachronous tumors.
Observation:
- Five patients underwent secondary mandibular reconstruction with two sequential osteocutaneous free flaps.
- Various flap combinations were used, including fibular, radial forearm, and scapular flaps.
- Osteosynthesis was achieved using plates, miniplates, or compression screws.
Findings:
- All five patients demonstrated solid bone-to-bone healing between the first and second free vascularized bone grafts.
- Patient survival ranged from 4 months to over 3 years, with two patients remaining disease-free for over 3 years.
Implications:
- Successful bone-to-bone union in secondary mandibular reconstruction can enhance patient quality of life.
- This procedure may offer palliative benefits for patients with recurrent or metachronous oral cavity tumors requiring repeat resection and reconstruction.