Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes
Identifieur interne : 004191 ( Main/Exploration ); précédent : 004190; suivant : 004192Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes
Auteurs : Nichole R. Dean [États-Unis] ; Mark K. Wax [États-Unis] ; Frank W. Virgin [États-Unis] ; J. Scott Magnuson [États-Unis] ; William R. Carroll [États-Unis] ; Eben L. Rosenthal [États-Unis]Source :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [ 0194-5998 ] ; 2011.
Abstract
To compare outcomes following osteocutaneous radial forearm and fibula free flap reconstruction of lateral mandibular defects.
Retrospective case controlled study.
Two academic tertiary care centers.
Patients who underwent free flap reconstruction of lateral mandibular defects from 1999 to 2010 were classified into four groups based on type of reconstruction: 1) radial forearm swing (n = 8), 2) radial forearm with bar (n = 5), 3) osteocutaneous radial forearm (n = 73) and 4) fibula free flap reconstruction (n = 51). Patient characteristics, length of hospital stay, recipient and donor site complications, and long term outcomes including postoperative diet were evaluated.
The majority of patients were male (67%) and presented with advanced T-stage (73%) squamous cell carcinoma (93%) involving the alveolus (26%) retromolar trigone (21%) or oral tongue (25%). Median length of hospital stay was 8 days (range 4–22). The recipient site complication rate approached 34% and included infection (n=11), mandibular malunion (n=9), exposed bone or mandibular plates (n=11) and flap failure (n=5). Most patients demonstrated little to no trismus following reconstruction (81%) and were able to resume a regular or edentulous diet (61%). No difference in complication rates or postoperative outcomes was seen between osteocutaneous radial forearm and fibula free flap groups (
The osteocutaneous radial forearm and fibula free flap provide equivalent wound healing and functional outcomes in patients undergoing lateral mandibular defect reconstruction.
Url:
DOI: 10.1177/0194599811430897
PubMed: 22166963
PubMed Central: 3589763
Affiliations:
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Dean</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Alabama</region></placeName><wicri:cityArea>Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham</wicri:cityArea></affiliation></author><author><name sortKey="Wax, Mark K" sort="Wax, Mark K" uniqKey="Wax M" first="Mark K." last="Wax">Mark K. Wax</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Surgery, Division of Otolaryngology, Oregon Health and Science University, Portland, Oregon</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Oregon</region></placeName><wicri:cityArea>Department of Surgery, Division of Otolaryngology, Oregon Health and Science University, Portland</wicri:cityArea></affiliation></author><author><name sortKey="Virgin, Frank W" sort="Virgin, Frank W" uniqKey="Virgin F" first="Frank W." last="Virgin">Frank W. Virgin</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Alabama</region></placeName><wicri:cityArea>Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham</wicri:cityArea></affiliation></author><author><name sortKey="Magnuson, J Scott" sort="Magnuson, J Scott" uniqKey="Magnuson J" first="J. Scott" last="Magnuson">J. Scott Magnuson</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Alabama</region></placeName><wicri:cityArea>Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham</wicri:cityArea></affiliation></author><author><name sortKey="Carroll, William R" sort="Carroll, William R" uniqKey="Carroll W" first="William R." last="Carroll">William R. Carroll</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Alabama</region></placeName><wicri:cityArea>Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham</wicri:cityArea></affiliation></author><author><name sortKey="Rosenthal, Eben L" sort="Rosenthal, Eben L" uniqKey="Rosenthal E" first="Eben L." last="Rosenthal">Eben L. Rosenthal</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Alabama</region></placeName><wicri:cityArea>Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, University of Alabama at Birmingham, Birmingham</wicri:cityArea></affiliation></author></analytic><series><title level="j">Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</title><idno type="ISSN">0194-5998</idno><idno type="eISSN">1097-6817</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To compare outcomes following osteocutaneous radial forearm and fibula free flap reconstruction of lateral mandibular defects.</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Retrospective case controlled study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">Two academic tertiary care centers.</p></sec><sec id="S4"><title>Subjects and Methods</title><p id="P4">Patients who underwent free flap reconstruction of lateral mandibular defects from 1999 to 2010 were classified into four groups based on type of reconstruction: 1) radial forearm swing (n = 8), 2) radial forearm with bar (n = 5), 3) osteocutaneous radial forearm (n = 73) and 4) fibula free flap reconstruction (n = 51). Patient characteristics, length of hospital stay, recipient and donor site complications, and long term outcomes including postoperative diet were evaluated.</p></sec><sec id="S5"><title>Results</title><p id="P5">The majority of patients were male (67%) and presented with advanced T-stage (73%) squamous cell carcinoma (93%) involving the alveolus (26%) retromolar trigone (21%) or oral tongue (25%). Median length of hospital stay was 8 days (range 4–22). The recipient site complication rate approached 34% and included infection (n=11), mandibular malunion (n=9), exposed bone or mandibular plates (n=11) and flap failure (n=5). Most patients demonstrated little to no trismus following reconstruction (81%) and were able to resume a regular or edentulous diet (61%). No difference in complication rates or postoperative outcomes was seen between osteocutaneous radial forearm and fibula free flap groups (<italic>P</italic> > 0.05). One patient underwent dental implantation following osteocutaneous radial forearm free flap reconstruction. No patients from the fibula free flap group underwent dental implantation.</p></sec><sec id="S6"><title>Conclusion</title><p id="P6">The osteocutaneous radial forearm and fibula free flap provide equivalent wound healing and functional outcomes in patients undergoing lateral mandibular defect reconstruction.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Alabama</li><li>Oregon</li></region></list><tree><country name="États-Unis"><region name="Alabama"><name sortKey="Dean, Nichole R" sort="Dean, Nichole R" uniqKey="Dean N" first="Nichole R." last="Dean">Nichole R. Dean</name></region><name sortKey="Carroll, William R" sort="Carroll, William R" uniqKey="Carroll W" first="William R." last="Carroll">William R. Carroll</name><name sortKey="Magnuson, J Scott" sort="Magnuson, J Scott" uniqKey="Magnuson J" first="J. Scott" last="Magnuson">J. Scott Magnuson</name><name sortKey="Rosenthal, Eben L" sort="Rosenthal, Eben L" uniqKey="Rosenthal E" first="Eben L." last="Rosenthal">Eben L. Rosenthal</name><name sortKey="Virgin, Frank W" sort="Virgin, Frank W" uniqKey="Virgin F" first="Frank W." last="Virgin">Frank W. Virgin</name><name sortKey="Wax, Mark K" sort="Wax, Mark K" uniqKey="Wax M" first="Mark K." last="Wax">Mark K. Wax</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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