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Mandible reconstruction with vascularized bone grafts. A histologic evaluation
H T Hoffman1, N Harrison, M J Sullivan
1Department of Surgery, University of California, San Diego, Medical Center.
Archives of Otolaryngology--Head & Neck Surgery
|August 1, 1991
Summary
Histologic evaluation of vascularized bone grafts in mandible reconstruction reveals successful bone healing and survival in viable grafts. Graft resorption and fibrous union occurred in a failed graft due to pedicle thrombosis.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthopedic Surgery
- Regenerative Medicine
Background:
- Mandible reconstruction often utilizes vascularized bone grafts.
- Histologic evidence of bone healing in these grafts is crucial for understanding outcomes.
- Previous studies have lacked detailed histologic analysis of graft healing and union.
Observation:
- Four patients requiring mandible reconstruction removal provided specimens for serial section histologic evaluation.
- A failed scapular graft with pectoralis major myocutaneous flap showed resorption and fibrous union.
- Successful grafts (iliac and scapular osteocutaneous) demonstrated viable bone and continuity with the native mandible.
Findings:
- Vascularized bone grafts can achieve successful histologic union and survival in mandible reconstruction.
- Graft resorption and fibrous union are associated with vascular compromise (pedicle thrombosis).
- Histology confirms healthy bone continuity between viable grafts and the native mandible.
Implications:
- Findings support the use of vascularized bone grafts for mandible reconstruction.
- Techniques for bone plating and graft vascularity are critical for successful outcomes.
- Histologic evaluation provides valuable insights into bone graft survival and union mechanisms.