Free flap reconstruction of osteoradionecrosis of the mandible: a 10-year review and defect classification.

Abstract

BACKGROUND:

The purpose of this study was to evaluate outcomes of free flap reconstruction for advanced osteoradionecrosis (ORN) defects and develop an algorithm to guide surgical planning.

METHODS:

All cases involving free flap reconstruction for ORN of the mandible between 1998 and 2008 were reviewed. A defect classification scheme was developed. Flap selection and outcomes were analyzed and evaluated by defect type.

RESULTS:

Seventy-five free flaps and 13 pedicle flaps were performed in 63 patients. Total flap loss was 5%. Overall surgical complication was 32%. Complication rates were higher with bone flaps than with soft tissue flaps (p = .018). A full oral diet was tolerated in 57% of patients, whereas 26% required partial tube feeding, and 16% were tube-feeding dependent.

CONCLUSION:

Free flap reconstruction of advanced ORN defects can be safely performed in a variety of flap configurations with good outcomes. The classification scheme may assist in flap selection.

• Authors: Donald P Baumann, Peirong Yu, Matthew M Hanasono, Roman J Skoracki
• Journal: Head & neck (Head Neck) Vol. 33 Issue 6 Pg. 800-7 (Jun 2011) ISSN: 1097-0347 [Electronic] United States
• PMID: 21560178 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2010 Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Aged, 80 and over
• Bone Transplantation (methods)
• Cohort Studies
• Female
• Follow-Up Studies
• Free Tissue Flaps (blood supply)
• Graft Rejection
• Graft Survival
• Head and Neck Neoplasms (pathology, radiotherapy, surgery)
• Humans
• Male
• Mandibular Diseases (classification, diagnostic imaging, surgery)
• Middle Aged
• Muscle, Skeletal (surgery, transplantation)
• Osteoradionecrosis (classification, diagnostic imaging, surgery)
• Quality of Life
• Radiotherapy Dosage
• Plastic Surgery Procedures (methods)
• Retrospective Studies
• Risk Assessment
• Tomography, X-Ray Computed (methods)
• Treatment Outcome