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Related Experiment Videos

Lateral mandibular reconstruction using soft-tissue free flaps and plates

K E Blackwell1, D Buchbinder, M L Urken

  • 1Division of Head and Neck Surgery, University of California School of Medicine, Los Angeles, USA.

Archives of Otolaryngology--Head & Neck Surgery
|June 1, 1996
PubMed
Summary

Reconstruction of lateral mandibular defects using soft-tissue free flaps and plates showed a 40% failure rate. Vascularized bone-containing free flaps are preferred for better long-term outcomes in head and neck cancer patients.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Plastic Surgery
  • Head and Neck Oncology

Background:

  • Segmental lateral mandibular defects often result from head and neck cancer treatment.
  • Reconstruction aims to restore mandibular continuity and function.
  • Previous methods combined soft-tissue free flaps with rigid fixation plates.

Purpose of the Study:

  • To assess the outcomes of mandibular reconstruction using soft-tissue free flaps and reconstruction plates.
  • To evaluate early and delayed complications associated with this technique.

Main Methods:

  • Retrospective case series of 15 patients with lateral mandibular defects.
  • Reconstruction involved soft-tissue free flaps (radial forearm, rectus abdominis, etc.) and mandibular reconstruction plates (titanium or stainless steel).

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  • Patients received preoperative or postoperative radiation therapy.

    • Main Results:

    • All 15 microvascular free tissue transfers were successful; early complications were minor (33%).
    • Delayed complications included plate fracture (1 patient) and plate exposure (3 patients), leading to a 40% overall delayed reconstructive failure rate after 1 year.
    • Secondary reconstruction with vascularized bone flaps was required for patients with delayed plate exposure.

    Conclusions:

    • The combination of soft-tissue free flaps and mandibular reconstruction plates has a high rate of delayed failure.
    • Vascularized bone-containing free flaps are recommended for optimal long-term results in these reconstructions.
    • This technique is largely abandoned in favor of more robust reconstructive options.