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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
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A retrospective study on mandibular reconstruction using iliac crest free flap.

Ata Garajei1,2, Ali A Kheradmand2,3, Seyed Roohollah Miri2,4

  • 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

Annals of Medicine and Surgery (2012)
|May 24, 2021
PubMed
Summary

The microvascular iliac crest free flap is a successful option for reconstructing mandibular defects, with primary reconstructions showing better outcomes. Smoking and diabetes may increase complication risks.

Keywords:
FlapIliac crestMandibularReconstructionSegmental

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Plastic and Reconstructive Surgery
  • Oncology

Background:

  • Mandibular segmental defects often result from tumor resection or trauma.
  • Reconstruction aims to restore function and aesthetics.
  • Microvascular free flaps offer a viable solution for complex defects.

Purpose of the Study:

  • To evaluate the efficacy of the microvascular iliac crest free flap for mandibular reconstruction.
  • To assess flap survival rates and postoperative complications.
  • To identify factors influencing reconstruction success.

Main Methods:

  • Retrospective-descriptive study of 30 patients undergoing mandibular resection and reconstruction.
  • Iliac crest microvascular free flap used between 2016-2019.
  • Statistical analysis (t-test, Kolmogorov-Smirnov, multivariate) to determine significance (p<0.05).

Main Results:

  • A total of 30 patients (16 female, 14 male; average age 27.2) were analyzed.
  • Flap success rate was high, with one flap loss due to venous thrombosis.
  • Complications were associated with smoking, diabetes (p=0.036), and osteogenic sarcoma (p<0.01).
  • Primary reconstructions (23 patients) were more successful than secondary reconstructions (p=0.003).

Conclusions:

  • Microvascular iliac crest free flap is a promising technique for mandibular reconstruction.
  • It offers good contour and acceptable success rates with low donor site morbidity.
  • Further research is needed on systemic diseases' impact on complications and flap failure.